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| Micro = tumour with variable architecture (nested, trabecular or lobular), small-to-moderate cytoplasm, +/-distinct nucleoli, cell size variable (small to large); glandular and squamous differentiation are absent by definition | | Micro = tumour with variable architecture (nested, trabecular or lobular), small-to-moderate cytoplasm, +/-distinct nucleoli, cell size variable (small to large); glandular and squamous differentiation are absent by definition | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = poorly differentiated [[squamous cell carcinoma of the head and neck]], [[small cell carcinoma]], SMARCB1-deficient sinonasal carcinoma, others | | LMDDx = poorly differentiated [[squamous cell carcinoma of the head and neck]], [[small cell carcinoma]], [[SMARCB1-deficient sinonasal carcinoma]], [[SMARCA4-deficient sinonasal carcinoma]], [[nasopharyngeal carcinoma]], others | ||
| Stains = | | Stains = | ||
| IHC = pankeratin +ve, [[EMA]] +ve, [[CK7]] +ve, [[CK5/6]] -ve, NSE +ve/-ve, chromogranin A -ve, synaptophysin -ve, [[p63]] +ve/-ve | | IHC = pankeratin +ve, [[EMA]] +ve, [[CK7]] +ve, [[CK5/6]] -ve, NSE +ve/-ve, chromogranin A -ve, synaptophysin -ve, [[p63]] +ve/-ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = [[EBER]] -ve | ||
| IF = | | IF = | ||
| Gross = | | Gross = | ||
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*Poorly differentiated [[squamous cell carcinoma of the head and neck]]. | *Poorly differentiated [[squamous cell carcinoma of the head and neck]]. | ||
*[[Small cell carcinoma]]. | *[[Small cell carcinoma]]. | ||
*SMARCB1-deficient sinonasal carcinoma.<ref name=pmid25007146>{{Cite journal | last1 = Bishop | first1 = JA. | last2 = Antonescu | first2 = CR. | last3 = Westra | first3 = WH. | title = SMARCB1 (INI-1)-deficient carcinomas of the sinonasal tract. | journal = Am J Surg Pathol | volume = 38 | issue = 9 | pages = 1282-9 | month = Sep | year = 2014 | doi = 10.1097/PAS.0000000000000285 | PMID = 25007146 }}</ref> | *[[SMARCB1-deficient sinonasal carcinoma]].<ref name=pmid25007146>{{Cite journal | last1 = Bishop | first1 = JA. | last2 = Antonescu | first2 = CR. | last3 = Westra | first3 = WH. | title = SMARCB1 (INI-1)-deficient carcinomas of the sinonasal tract. | journal = Am J Surg Pathol | volume = 38 | issue = 9 | pages = 1282-9 | month = Sep | year = 2014 | doi = 10.1097/PAS.0000000000000285 | PMID = 25007146 }}</ref> | ||
*Other tumours. | *[[SMARCA4-deficient sinonasal carcinoma]].<ref name=pmid34871352>{{cite journal |authors=Kakkar A, Ashraf SF, Rathor A, Adhya AK, Mani S, Sikka K, Jain D |title=SMARCA4/BRG1-Deficient Sinonasal Carcinoma |journal=Arch Pathol Lab Med |volume=146 |issue=9 |pages=1122–1130 |date=September 2022 |pmid=34871352 |doi=10.5858/arpa.2021-0001-OA |url=}}</ref> | ||
*[[Nasopharyngeal carcinoma]]. | |||
*Other tumours, especially [[small round blue cell tumours]] and [[lymphoma]]. | |||
===Images=== | ===Images=== | ||
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*Synaptophysin -ve. | *Synaptophysin -ve. | ||
*p63 +ve/-ve.<ref name=pmid21805120>{{Cite journal | last1 = Wadsworth | first1 = B. | last2 = Bumpous | first2 = JM. | last3 = Martin | first3 = AW. | last4 = Nowacki | first4 = MR. | last5 = Jenson | first5 = AB. | last6 = Farghaly | first6 = H. | title = Expression of p16 in sinonasal undifferentiated carcinoma (SNUC) without associated human papillomavirus (HPV). | journal = Head Neck Pathol | volume = 5 | issue = 4 | pages = 349-54 | month = Dec | year = 2011 | doi = 10.1007/s12105-011-0285-8 | PMID = 21805120 | PMC = 3210220 | URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210220/ }}</ref> | *p63 +ve/-ve.<ref name=pmid21805120>{{Cite journal | last1 = Wadsworth | first1 = B. | last2 = Bumpous | first2 = JM. | last3 = Martin | first3 = AW. | last4 = Nowacki | first4 = MR. | last5 = Jenson | first5 = AB. | last6 = Farghaly | first6 = H. | title = Expression of p16 in sinonasal undifferentiated carcinoma (SNUC) without associated human papillomavirus (HPV). | journal = Head Neck Pathol | volume = 5 | issue = 4 | pages = 349-54 | month = Dec | year = 2011 | doi = 10.1007/s12105-011-0285-8 | PMID = 21805120 | PMC = 3210220 | URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210220/ }}</ref> | ||
*SMARCB1 ([[INI1]]) +ve (nuclear staining present). | |||
**Nuclear staining lost in [[SMARCB1-deficient sinonasal carcinoma]]. | |||
===Comparison between different sinonasal carcinomas=== | |||
Based on a modest size study, keratins can useful for subclassifying sinonasal carcinomas:<ref name=pmid12459626>{{cite journal |authors=Franchi A, Moroni M, Massi D, Paglierani M, Santucci M |title=Sinonasal undifferentiated carcinoma, nasopharyngeal-type undifferentiated carcinoma, and keratinizing and nonkeratinizing squamous cell carcinoma express different cytokeratin patterns |journal=Am J Surg Pathol |volume=26 |issue=12 |pages=1597–604 |date=December 2002 |pmid=12459626 |doi=10.1097/00000478-200212000-00007 |url=}}</ref> | |||
{| class="wikitable sortable" | |||
! Diagnosis | |||
! CK4 | |||
! CK5/6 | |||
! CK7 | |||
! CK13 | |||
! CK14 | |||
! CK19 | |||
|- | |||
| Sinonasal undifferentiated carcinoma (SNUC) | |||
| +0% | |||
| +0% | |||
| +50% | |||
| +0% | |||
| +0% | |||
| +50% | |||
|- | |||
| Nasopharyngeal-type undifferentiated carcinoma (NPTC) | |||
| +0% | |||
| +80% | |||
| +0% | |||
| +80% | |||
| +0% | |||
| +100% | |||
|- | |||
| Nonkeratinizing squamous cell carcinoma (NKSCC) | |||
| +0% | |||
| +90% | |||
| +0% | |||
| +80% | |||
| +80% | |||
| +90% | |||
|- | |||
|Squamous cell carcinoma (keratainizing) | |||
| +30% | |||
| +90% | |||
| +60% | |||
| +90% | |||
| +80% | |||
| +90% | |||
|- | |||
|} | |||
==Molecular== | |||
*EBER -ve.<ref name=pmid11176064>{{cite journal |authors=Cerilli LA, Holst VA, Brandwein MS, Stoler MH, Mills SE |title=Sinonasal undifferentiated carcinoma: immunohistochemical profile and lack of EBV association |journal=Am J Surg Pathol |volume=25 |issue=2 |pages=156–63 |date=February 2001 |pmid=11176064 |doi=10.1097/00000478-200102000-00003 |url=}}</ref> | |||
==See also== | ==See also== |
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