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'''Nasopharyngeal carcinoma''', abbreviated '''NPC''', is malignant epithelial tumour of the [[Head and neck pathology|head and neck]] closely related to [[squamous cell carcinoma]]. | |||
==General== | |||
*"Nasopharyngeal carcinoma" is the name of an entity - it is not a descriptive term. | |||
*Strong association with [[Epstein-Barr virus]] (EBV). | |||
Note: | |||
*A morphologically identical tumour elsewhere is called ''[[lymphoepithelioma-like carcinoma]]''. | |||
==Gross== | |||
*Nasopharynx - as the name would suggest. | |||
==Microscopic== | |||
Features:<ref name=Ref_Klatt145>{{Ref Klatt|145}}</ref> | |||
*Prominent lymphoid component - '''key feature'''. | |||
*Features of squamous cell carcinoma: | |||
**Cohesive cells with: | |||
***Abundant dense eosinophilic cytoplasm. | |||
***Central nuclei +/- small/indistinct nucleoli. | |||
===Images=== | |||
<gallery> | |||
Image:Lymphoepithelioma_met_to_LN_4.jpg | Nasopharyngeal carcinoma - in a LN - low mag. (WC) | |||
Image:Lymphoepithelioma_met_to_LN_6.jpg | Nasopharyngeal carcinoma - in a LN - intermed. mag. (WC) | |||
Image:Lymphoepithelioma_met_to_LN_2.jpg | Nasopharyngeal carcinoma - in a LN - high mag. (WC) | |||
</gallery> | |||
===Histologic subclassification=== | |||
World Health Classification (2005) for NPC:<ref name=Ref_WMSP39>{{Ref WMSP|39}}</ref> | |||
{| class="wikitable" | |||
! Type | |||
! Histology | |||
! Description | |||
! EBV | |||
! Prevalence | |||
! Prognosis | |||
|- | |||
| 1 | |||
| keratinizing SCC | |||
| graded poorly-well-diff. | |||
| -ve | |||
| ? | |||
| bad | |||
|- | |||
| 2a | |||
| nonkeratinizing carcinoma, differentiated | |||
| well def. cell borders & tumour nest borders, mimics appearance of [[UCC]] | |||
| +ve | |||
| ? | |||
| good | |||
|- | |||
| 2b | |||
| nonkeratinizing carcinoma, undifferentiated | |||
| sheets/syncytial, vescicular nuclei, prominent nucleoli, pink cytoplasm | |||
| ? | |||
| most common | |||
| ? | |||
|- | |||
| 3 | |||
| basaloid SCC | |||
| mimics BCC - see [[basaloid SCC]] | |||
| ? | |||
| least common | |||
| ? | |||
|} | |||
How to remember ''KNUB'': | |||
*'''K'''eratinizing, '''N'''on-keratinizing diff., non-keratinizing '''U'''ndiff., '''B'''asaloid SCC. | |||
==IHC== | |||
*EBER +ve. | |||
*p16 -ve.<ref name=pmid9546345>{{cite journal |author=Gulley ML, Nicholls JM, Schneider BG, Amin MB, Ro JY, Geradts J |title=Nasopharyngeal carcinomas frequently lack the p16/MTS1 tumor suppressor protein but consistently express the retinoblastoma gene product |journal=Am. J. Pathol. |volume=152 |issue=4 |pages=865–9 |year=1998 |month=April |pmid=9546345 |pmc=1858242 |doi= |url=}}</ref> | |||
Notes: | |||
*[[HPV-associated head and neck squamous cell carcinoma]]s are p16 +ve.<ref name=pmid21484924>{{Cite journal | last1 = Singhi | first1 = AD. | last2 = Califano | first2 = J. | last3 = Westra | first3 = WH. | title = High-risk human papillomavirus in nasopharyngeal carcinoma. | journal = Head Neck | volume = 34 | issue = 2 | pages = 213-8 | month = Feb | year = 2012 | doi = 10.1002/hed.21714 | PMID = 21484924 }}</ref> | |||
==See also== | |||
*[[Head and neck pathology]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Head and neck pathology]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||