Difference between revisions of "NUT carcinoma"

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'''NUT midline carcinoma''', abbreviated '''NMC''', is a super rare tumour of the [[head and neck pathology|head and neck]].  The WHO calls this tumour '''carcinoma with t(15;19) translocation'''.<ref name=Ref_WMSP145>{{Ref WMSP|145}}</ref>
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = NUT_midline_carcinoma_-_very_high_mag.jpg
| Width      =
| Caption    = NUT carcinoma. [[H&E stain]].
| Synonyms  = NUT midline carcinoma, carcinoma with t(15;19) translocation
| Micro      = cohesive malignant cells (poorly differentiated carcinoma), islands of well-differentiated squamous epithelium
| Subtypes  =
| LMDDx      = [[Carcinoma ex pleomorphic adenoma]], [[squamous cell carcinoma]], [[SMARCB1-deficient sinonasal carcinoma]], acute leukemia, poorly differentiated carcinoma,
| Stains    =
| IHC        = p63 +ve, CD34 +ve/-ve, EMA +ve, NUT +ve
| EM        =
| Molecular  = t(15;19)
| IF        =
| Gross      =
| Grossing  =
| Site      = [[head and neck pathology|head and neck]], [[mediastinum]], usu. midline
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = very rare
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = very poor
| Other      =
| ClinDDx    =
}}
'''NUT carcinoma''' is a rare malignant tumour classically of the [[head and neck pathology|head and neck]].  The [[World Health Organization|WHO]] calls this tumour '''carcinoma with t(15;19) translocation'''.<ref name=Ref_WMSP145>{{Ref WMSP|145}}</ref> It is also known as '''NUT midline carcinoma''', abbreviated '''NMC'''.


==General==
==General==
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DDx:
DDx:
*[[Squamous cell carcinoma]].
*[[Carcinoma ex pleomorphic adenoma]].
*[[Carcinoma ex pleomorphic adenoma]].
*Poorly differentiated carcinoma.
*Poorly differentiated 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>
*Acute leukemia - especially as ''NUT carcinoma'' may be CD34 positive.<ref name=pmid>{{Cite journal  | last1 = Li | first1 = W. | last2 = Chastain | first2 = K. | title = NUT midline carcinoma with leukemic presentation mimicking CD34-positive acute leukemia. | journal = Blood | volume = 132 | issue = 4 | pages = 456 | month = Jul | year = 2018 | doi = 10.1182/blood-2017-07-796268 | PMID = 30049733 }}</ref>
===Images===
<gallery>
Image:NUT_midline_carcinoma_-_high_mag.jpg | NUT midline carcinoma - high mag. (WC)
Image:NUT_midline_carcinoma_-_very_high_mag.jpg | NUT midline carcinoma - very high mag. (WC)
</gallery>


==Molecular==
==Molecular==
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**Most common: t(15;19)(q13;p13.1) ''BRD4/NUT''.<ref>{{OMIM|608749}}</ref>
**Most common: t(15;19)(q13;p13.1) ''BRD4/NUT''.<ref>{{OMIM|608749}}</ref>
***One source suggests it is: ''t(15;19)(q14;p13.1)''.<ref name=pmid18552174>{{Cite journal  | last1 = French | first1 = CA. | title = Demystified molecular pathology of NUT midline carcinomas. | journal = J Clin Pathol | volume = 63 | issue = 6 | pages = 492-6 | month = Jun | year = 2010 | doi = 10.1136/jcp.2007.052902 | PMID = 18552174 }}</ref>
***One source suggests it is: ''t(15;19)(q14;p13.1)''.<ref name=pmid18552174>{{Cite journal  | last1 = French | first1 = CA. | title = Demystified molecular pathology of NUT midline carcinomas. | journal = J Clin Pathol | volume = 63 | issue = 6 | pages = 492-6 | month = Jun | year = 2010 | doi = 10.1136/jcp.2007.052902 | PMID = 18552174 }}</ref>
==IHC==
*NUT +ve ('''key immunostain''').
*CD34 +ve seen in ~50% of cases.<ref name=pmid21221870>{{Cite journal  | last1 = Stelow | first1 = EB. | title = A review of NUT midline carcinoma. | journal = Head Neck Pathol | volume = 5 | issue = 1 | pages = 31-5 | month = Mar | year = 2011 | doi = 10.1007/s12105-010-0235-x | PMID = 21221870 }}</ref>
*p63 +ve.<ref name=pmid22534723>{{Cite journal  | last1 = Bishop | first1 = JA. | last2 = Westra | first2 = WH. | title = NUT midline carcinomas of the sinonasal tract. | journal = Am J Surg Pathol | volume = 36 | issue = 8 | pages = 1216-21 | month = Aug | year = 2012 | doi = 10.1097/PAS.0b013e318254ce54 | PMID = 22534723 }}</ref>
*EMA +ve.
*p16 +ve (4 of 4 cases).<ref name=pmid24185123>{{Cite journal  | last1 = Salles | first1 = PG. | last2 = Moura | first2 = Rde D. | last3 = Menezes | first3 = LM. | last4 = Bacchi | first4 = CE. | title = Expression of P16 in NUT carcinomas with no association with human papillomavirus (HPV). | journal = Appl Immunohistochem Mol Morphol | volume = 22 | issue = 4 | pages = 262-5 | month = Apr | year = 2014 | doi = 10.1097/PAI.0b013e3182a4ef2e | PMID = 24185123 }}</ref>
*Ki-67 >80% of tumour cells.{{fact}}
*CK7 +ve.<ref name=pmid25549144>{{Cite journal  | last1 = Zhu | first1 = S. | last2 = Schuerch | first2 = C. | last3 = Hunt | first3 = J. | title = Review and updates of immunohistochemistry in selected salivary gland and head and neck tumors. | journal = Arch Pathol Lab Med | volume = 139 | issue = 1 | pages = 55-66 | month = Jan | year = 2015 | doi = 10.5858/arpa.2014-0167-RA | PMID = 25549144 }}</ref>


==See also==
==See also==
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