Difference between revisions of "NUT carcinoma"

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| LMDDx      = [[Carcinoma ex pleomorphic adenoma]], poorly differentiated carcinoma
| LMDDx      = [[Carcinoma ex pleomorphic adenoma]], poorly differentiated carcinoma
| Stains    =
| Stains    =
| IHC        =
| IHC        = p63 +ve, CD34 +ve/-ve, EMA +ve
| EM        =
| EM        =
| Molecular  = t(15;19)
| Molecular  = t(15;19)
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*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>
*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 midline 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===
===Images===
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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==
*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.


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

Revision as of 19:26, 17 September 2018

NUT carcinoma
Diagnosis in short

NUT midline carcinoma. H&E stain.

Synonyms NUT carcinoma, carcinoma with t(15;19) translocation

LM cohesive malignant cells (poorly differentiated carcinoma), islands of well-differentiated squamous epithelium
LM DDx Carcinoma ex pleomorphic adenoma, poorly differentiated carcinoma
IHC p63 +ve, CD34 +ve/-ve, EMA +ve
Molecular t(15;19)
Site head and neck, mediastinum, usu. midline

Prevalence very rare
Prognosis very poor

NUT midline carcinoma, abbreviated NMC, is a rare tumour of the head and neck. The WHO calls this tumour carcinoma with t(15;19) translocation.[1] It is also known as NUT carcinoma.

General

  • Not specific to any tissue type or organ.[2]
  • Defined by mutation in NUT gene on chromosome 15.
    • NUT = Nuclear protein in testis.[3]

Clinical:

  • Usually midline - as the name of the tumour suggests.
    • Case report of a NMC in the parotid gland.[4]
  • Head, neck and mediastinum.[5]
  • Very poor prognosis.[4]

Microscopic

Features:[2][5]

  • Poorly differentiated carcinoma.
    • Cohesive malignant cells.
  • Islands of well-differentiated squamous epithelium - key feature.

DDx:

Images

Molecular

  • Rearrangement of the NUT gene.[2]
    • Most common: t(15;19)(q13;p13.1) BRD4/NUT.[8]
      • One source suggests it is: t(15;19)(q14;p13.1).[5]

IHC

  • CD34 +ve seen in ~50% of cases.[9]
  • p63 +ve.[10]
  • EMA +ve.

See also

References

  1. Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 145. ISBN 978-0781765275.
  2. 2.0 2.1 2.2 French, CA. (Nov 2010). "NUT midline carcinoma.". Cancer Genet Cytogenet 203 (1): 16-20. doi:10.1016/j.cancergencyto.2010.06.007. PMID 20951314.
  3. Online 'Mendelian Inheritance in Man' (OMIM) 608963
  4. 4.0 4.1 den Bakker, MA.; Beverloo, BH.; van den Heuvel-Eibrink, MM.; Meeuwis, CA.; Tan, LM.; Johnson, LA.; French, CA.; van Leenders, GJ. (Aug 2009). "NUT midline carcinoma of the parotid gland with mesenchymal differentiation.". Am J Surg Pathol 33 (8): 1253-8. doi:10.1097/PAS.0b013e3181abe120. PMID 19561446.
  5. 5.0 5.1 5.2 French, CA. (Jun 2010). "Demystified molecular pathology of NUT midline carcinomas.". J Clin Pathol 63 (6): 492-6. doi:10.1136/jcp.2007.052902. PMID 18552174.
  6. Bishop, JA.; Antonescu, CR.; Westra, WH. (Sep 2014). "SMARCB1 (INI-1)-deficient carcinomas of the sinonasal tract.". Am J Surg Pathol 38 (9): 1282-9. doi:10.1097/PAS.0000000000000285. PMID 25007146.
  7. Li, W.; Chastain, K. (Jul 2018). "NUT midline carcinoma with leukemic presentation mimicking CD34-positive acute leukemia.". Blood 132 (4): 456. doi:10.1182/blood-2017-07-796268. PMID 30049733.
  8. Online 'Mendelian Inheritance in Man' (OMIM) 608749
  9. Stelow, EB. (Mar 2011). "A review of NUT midline carcinoma.". Head Neck Pathol 5 (1): 31-5. doi:10.1007/s12105-010-0235-x. PMID 21221870.
  10. Bishop, JA.; Westra, WH. (Aug 2012). "NUT midline carcinomas of the sinonasal tract.". Am J Surg Pathol 36 (8): 1216-21. doi:10.1097/PAS.0b013e318254ce54. PMID 22534723.