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Difference between revisions of "NUT carcinoma"
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| Image = NUT_midline_carcinoma_-_very_high_mag.jpg | | Image = NUT_midline_carcinoma_-_very_high_mag.jpg | ||
| Width = | | Width = | ||
| Caption = NUT | | Caption = NUT carcinoma. [[H&E stain]]. | ||
| Synonyms = NUT carcinoma, carcinoma with t(15;19) translocation | | Synonyms = NUT midline carcinoma, carcinoma with t(15;19) translocation | ||
| Micro = cohesive malignant cells (poorly differentiated carcinoma), islands of well-differentiated squamous epithelium | | Micro = cohesive malignant cells (poorly differentiated carcinoma), islands of well-differentiated squamous epithelium | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[Carcinoma ex pleomorphic adenoma]], poorly differentiated carcinoma | | LMDDx = [[Carcinoma ex pleomorphic adenoma]], [[squamous cell carcinoma]], [[SMARCB1-deficient sinonasal carcinoma]], acute leukemia, poorly differentiated carcinoma, | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = p63 +ve, CD34 +ve/-ve, EMA +ve, NUT +ve | ||
| EM = | | EM = | ||
| Molecular = t(15;19) | | Molecular = t(15;19) | ||
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| ClinDDx = | | ClinDDx = | ||
}} | }} | ||
'''NUT | '''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== | ||
| Line 50: | Line 50: | ||
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> | *[[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=== | ===Images=== | ||
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==IHC== | ==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> | *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> | |||
**Rarely negative - case report.<ref name=pmid33176817>{{cite journal |authors=Numakura S, Saito K, Motoi N, Mori T, Saito Y, Yokote F, Kanamoto Y, Asami M, Sakai T, Yamauchi Y, Sakao Y, Uozaki H, Kawamura M |title=P63-negative pulmonary NUT carcinoma arising in the elderly: a case report |journal=Diagn Pathol |volume=15 |issue=1 |pages=134 |date=November 2020 |pmid=33176817 |pmc=7657348 |doi=10.1186/s13000-020-01053-4 |url=}}</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> | |||
Note: | |||
*p63 +ve with p40 -ve may be suggestive.{{fact}} | |||
==See also== | ==See also== | ||
*[[Head and neck pathology]]. | *[[Head and neck pathology]]. | ||