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Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: a clinicopathological and molecular study of four cases. Hum Pathol 2022; 134:66-73. [PMID: 36549599 DOI: 10.1016/j.humpath.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/06/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TLLGNPPA) is a rare nasopharyngeal carcinoma. To date, less than 60 cases of TLLGNPPA have been reported, and its clinical features and pathogenesis remain unclear. In this paper, four cases of TLLGNPPA were reported to clarify the clinicopathological and molecular features of this disease. Histopathological examination revealed that all tumors had papillary glandular arrangement, with a fibrovascular axis in the tumor stroma and focal nuclear groove. All tumors expressed pan-CK, CK7, and CK19, while TG and Pax-8 were negative, and the Ki-67 index was approximately 1-3%. The expression of TTF-1 was diffusely positive in two cases and focally positive in two cases. EBER was not expressed in four cases. Molecular testing was possible in three cases. No common driver event was noted, but unique, mutually exclusive molecular variants were found in each of the three tumors (FGFR4, PDK1, AXIN2, FOXL2, and PIK3C3), one also with copy number variants in MCL1 and STMN1. All four patients underwent surgical resection of the tumor and had no metastasis or recurrence from 7 to 60 months post-resection. Given the assertion that these tumors do not recur or metastasize in addition to their heterogeneous gene mutation spectrum, we propose that TLLGNPPA is a neoplasm with low malignant potential and should no longer to be referred to as an adenocarcinoma.
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Wang T, Liu X, Yu W, Gao L, Deng W, He Q, Liao F, Chu L. Genetic profile identification and clinicopathologic characteristics analysis of the thyroid-like low-grade nasopharyngeal papillary adenocarcinoma. Pathol Res Pract 2022; 236:153980. [PMID: 35759937 DOI: 10.1016/j.prp.2022.153980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/28/2022] [Accepted: 06/11/2022] [Indexed: 11/16/2022]
Abstract
Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is an extremely rare malignancy bearing histomorphological similarities to papillary thyroid carcinoma with good prognosis. It's important to distinguish TL-LGNPPA from other papillary tumors including nasopharyngeal papillary adenocarcinoma (NPPA), metastatic and ectopic papillary thyroid cancer, and metastasized adenocarcinomas, etc. To date, only 48 cases of TL-LGNPPA have been reported in the English literatures. Here, we reported the genomic characteristics of additional 4 cases and reviewed other reports to clarify the clinicopathological features of this tumor. In this study, 41 mutations were detected by whole-exome sequencing, but no typical driver mutations were found. Two sample with Copy Number Variations (CNV) were found (7 q22. 17 q12), of which the segment spanned the regions of RASA4, POLR2J2, SPDYE2, CCL3, CCL4, etc. Additionally, no MSI and HLA LOH were found. To our knowledge, we are the first to reveal the genetic underpinnings of this rare tumor. The clinicopathological features of TL-LGNPPA were characterized, shedding more light on the essential difference between TL-LGNPPA with other papillary tumors.
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Affiliation(s)
- Tiansheng Wang
- Department of Otolaryngology Head and Neck Surgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xinrong Liu
- Department of Pathology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wentao Yu
- Department of Pathology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lin Gao
- Geneplus-Beijing Institute, China
| | - Wenzhi Deng
- Department of Pathology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | | | - Feifei Liao
- Department of Pathology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ling Chu
- Department of Pathology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
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3
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Yi L, Liu H. Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma with squamous differentiation in the posterior nasal septum: A rare case report. Medicine (Baltimore) 2021; 100:e28349. [PMID: 34941144 PMCID: PMC8702276 DOI: 10.1097/md.0000000000028349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/01/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is a rare neoplasm characterized by papillary epithelial proliferation and abnormal expression of thyroid transcription factor-1. To our knowledge, squamous differentiation in TL-LGNPPA is an unusual phenomenon, and only 1 case has been reported to date. The tumor occurs mainly on the roof of the nasopharynx. Herein, we report a case of TL-LGNPPA with squamous differentiation located on the posterior nasal septum. PATIENT CONCERNS A 45-year-old Chinese women presented to our hospital with a complaint of nasal obstruction for 10 years and the symptom has been getting worse for recent 3 years. DIAGNOSES Microscopic examination of the tumor tissue revealed findings typical of TL-LGNPPA, and in addition to the typical components, squamous differentiation could be found in some areas within the fibrovascular cores of the papillary components. Immunohistochemically, the squamous cells were positive for P40 and P63 but negative for thyroid transcription factor-1. INTERVENTIONS The patient underwent complete resection of the tumor. OUTCOMES Follow up results showed that the patient had no recurrence 41 months after removal of the tumor. LESSONS Our report anticipates that, although TL-LGNPPA with squamous differentiation in the posterior nasal septum is rare, this report will expand the existing knowledge associated with TL-LGNPPA.
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Affiliation(s)
- Li Yi
- Department of Pathology, Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Honglei Liu
- Department of Neurosurgery, Shijiazhuang Third Hospital, Shijiazhuang, China
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4
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Takakura H, Hamashima T, Tachino H, Nakazato A, Minato H, Sasahara M, Shojaku H. Clinicopathological Features of Thyroid-Like Low-Grade Nasopharyngeal Papillary Adenocarcinoma: A Case Report and Review of the Literature. Front Surg 2020; 7:596796. [PMID: 33330610 PMCID: PMC7710863 DOI: 10.3389/fsurg.2020.596796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/26/2020] [Indexed: 11/20/2022] Open
Abstract
Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is an extremely rare neoplasm of the nasopharynx. Accordingly, its clinical and pathological characteristics are not well-known. We report a case of TL-LGNPPA and review the relevant literature on TL-LGNPPA. A 38-year-old Japanese woman presented with a history of nasal obstruction that had persisted for 1 month after symptoms of a common cold (e.g., low-grade fever, sore throat, and fatigue). A pedunculated tumor of ~20 mm in diameter was found on the posterior edge of the nasal septum. The tumor was endoscopically resected. Based on careful histopathological and immunohistochemical examinations, it was diagnosed as TL-LGNPPA. At 5 years after surgery, the patient remained disease-free. TL-LGNPPA has a very good prognosis, and complete resection with a sufficient safety margin is recommended as the first-line treatment. The morphological characteristics and immunohistochemical findings, especially TTF-1 positivity and thyroglobulin negativity, are important for the diagnosis.
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Affiliation(s)
- Hiromasa Takakura
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Takeru Hamashima
- Department of Pathology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Hirohiko Tachino
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Akira Nakazato
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Hiroshi Minato
- Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Masakiyo Sasahara
- Department of Pathology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Hideo Shojaku
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
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Compagnoni IM, Lamounier LA, Fontanini L, Silveira GT, Faria FM, Reis MBFD, Valera FCP. Complete endoscopic resection of low-grade nasopharyngeal papillary adenocarcinoma: a case report. Braz J Otorhinolaryngol 2020; 87:237-240. [PMID: 33272840 PMCID: PMC9422480 DOI: 10.1016/j.bjorl.2020.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 12/04/2022] Open
Affiliation(s)
- Inaê M Compagnoni
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Divisão de Otorrinolaringologia, Ribeirão Preto, SP, Brazil.
| | - Lorena A Lamounier
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Divisão de Otorrinolaringologia, Ribeirão Preto, SP, Brazil
| | - Letícia Fontanini
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Pediatria, Ribeirão Preto, SP, Brazil
| | - Gabriela T Silveira
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Divisão de Otorrinolaringologia, Ribeirão Preto, SP, Brazil
| | - Francesca M Faria
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Patologia, Ribeirão Preto, SP, Brazil
| | - Maristella B Francisco Dos Reis
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Pediatria, Ribeirão Preto, SP, Brazil
| | - Fabiana C P Valera
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Divisão de Otorrinolaringologia, Ribeirão Preto, SP, Brazil
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Theresia E, Dwianingsih EK, Rinonce HT, Cempaka R, Herdini C, Irianiwati. Primary thyroid-like low-grade nasopharyngeal papillary adenocarcinoma in a 11-year-old male patient: The first case report in Indonesia. HUMAN PATHOLOGY: CASE REPORTS 2020. [DOI: 10.1016/j.ehpc.2020.200392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Biphasic Thyroid-Like Low-Grade Nasopharyngeal Papillary Adenocarcinoma with a Prominent Spindle Cell Component: A Case Report. Diagnostics (Basel) 2020; 10:diagnostics10050323. [PMID: 32438756 PMCID: PMC7277985 DOI: 10.3390/diagnostics10050323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/12/2020] [Accepted: 05/15/2020] [Indexed: 11/17/2022] Open
Abstract
Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TLLG-NPPA) is a distinctly rare malignancy of the nasopharynx. Morphologically and immunophenotypically, TLLG-NPPA resembles papillary thyroid carcinoma (PTC) and is characterized by a papillary architecture with PTC-like nuclear features and thyroid transcription factor-1 expression. Recently, some cases of TLLG-NPPA with a spindle cell component have been reported. In this study, we report a very interesting case of biphasic TLLG-NPPA that was predominantly composed of spindle cells, with comprehensive analyses of its clinical, pathological, and immunophenotypical features. A 50-year-old woman presented with a sensation of a foreign body in the nasopharynx. Nasopharyngoscopy and computed tomography demonstrated a pedunculated mass arising from the nasopharyngeal roof. Based on the clinical impression of a nasopharyngeal tumor, an excisional biopsy was performed. At low-power magnification, the nasopharyngeal mass consisted of papillary tumor tissue, the growth pattern and architecture of which resembled those of PTC. The papillae were complex and packed tightly with fibrovascular cores. At high-power magnification, each papillary structure was lined with a pseudostratified cuboidal-to-columnar epithelium. The tumor cell nuclei frequently showed a ground-glass appearance, intranuclear grooves, pseudoinclusions, and membrane thickening and irregularity, resembling the characteristic nuclear morphology of PTC. These histological features were compatible with TLLG-NPPA. Intriguingly, in between the papillary components were spindle cells that appeared very similar to the glandular epithelial cells that imperceptibly merged with the papillary component. This spindle cell component comprised two-thirds of the entire tumor volume. The nuclear morphology of the spindle cell component was similar to that of the papillary component. On immunostaining, both the papillary and spindle cell components were diffusely and strongly positive for thyroid transcription factor-1, cytokeratin 7, cytokeratin 19, vimentin, and Hector Battifora mesothelial-1. In contrast, the tumor cells tested negative for p63, p40, smooth muscle actin, S-100, cytokeratin 5/6, thyroglobulin, BRAF V600E, and Epstein–Barr virus-encoded small RNAs. Only two cases of biphasic TLLG-NPPA exhibiting a prominent spindle cell component had been reported previously in the English literature. When the pathologist receives a primary nasopharyngeal mass with the aforementioned histological features, particularly biopsy specimens with predominant spindle cells, biphasic TLLG-NPPA should be considered in the differential diagnosis. By describing its detailed clinicopathological characteristics, we anticipate that this report will expand the existing knowledge on the spindle cell component associated with TLLG-NPPA.
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Huang F, Xiang X, Hong B, Min J, Li J. Thyroid-Like Low-Grade Nasopharyngeal Papillary Adenocarcinoma. Am J Clin Pathol 2019; 152:582-589. [PMID: 31287861 DOI: 10.1093/ajcp/aqz082] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TLLGNPPA) is a relatively rare nasopharyngeal tumor. We performed morphological characterization, immunohistochemical profiling, and investigated gene mutations. We also provide clinical follow-up data and brief review of the literature. METHODS Immunohistochemistry was used to evaluate the expression of TTF-1, CK19, CK7, EMA, TG, Pax-8, CK5/6, S100, and Ki-67. Additionally, in situ hybridization was utilized to identify the presence of EBV. We investigated mutations in hot-spot exons of KRAS/NRAS/BRAF to rule out common mutations seen in thyroid tumors. RESULTS Histopathologic examination of four cases identified tumors that were mainly occupied by papillary architectures. One case had a predominantly glandular structure. The tumors expressed TTF-1 and CK19, while TG and Pax-8 were negative. S100 was moderately expressed focally in three cases. CONCLUSIONS While TLLGNPPA displays a morphological resemblance to papillary thyroid carcinoma (PTC), it is vital to differentiate nasopharyngeal metastasis from PTC for appropriate treatment.
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Affiliation(s)
- Fengbo Huang
- Department of Pathology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province
| | - Xueping Xiang
- Department of Pathology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Bo Hong
- Department of Pathology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jie Min
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jinfan Li
- Department of Pathology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province
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9
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Le QV, Ngo DQ, Tran TD, Ngo QX. Primary Thyroid-Like Low-Grade Nasopharyngeal Papillary Adenocarcinoma. EAR, NOSE & THROAT JOURNAL 2019; 99:NP89-NP90. [PMID: 31146581 DOI: 10.1177/0145561319853257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Quang Van Le
- Department of Head and Neck Surgery, Vietnam National Cancer Hospital, Hanoi, Vietnam.,Department of Oncology, Hanoi Medical University, Dong Da District, Hanoi, Vietnam
| | - Duy Quoc Ngo
- Department of Head and Neck Surgery, Vietnam National Cancer Hospital, Hanoi, Vietnam
| | - Toan Duc Tran
- Department of Head and Neck Surgery, Vietnam National Cancer Hospital, Hanoi, Vietnam
| | - Quy Xuan Ngo
- Department of Head and Neck Surgery, Vietnam National Cancer Hospital, Hanoi, Vietnam
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Yokoi H, Terado Y, Fujiwara M, Matsumoto Y, Ikeda T, Saito K. Biphasic low-grade nasopharyngeal papillary adenocarcinoma: a case report and literature review. BMC Clin Pathol 2018; 18:10. [PMID: 30323715 PMCID: PMC6172832 DOI: 10.1186/s12907-018-0076-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 09/23/2018] [Indexed: 01/10/2023] Open
Abstract
Background Low-grade nasopharyngeal papillary adenocarcinoma (LGNPPA) is distinctly rare. We report a patient with a uniquely biphasic LGNPPA; additionally, we review similar tumors reported in the literature. Case presentation A 56-year-old man presented with an asymptomatic pedunculated tumor in the vault of the nasopharynx, at the junction of the nasal septum and the roof, which was discovered during screening for laryngeal cancer. To obtain a definitive diagnosis, the patient underwent endoscopic endonasal surgery under general anesthesia. Immunohistochemical analysis of the tumor revealed it to be an LGNPPA with a prominent spindle cell component. Conclusion To our knowledge, this is the fourth reported LGNPPA exhibiting a spindle cell component and the second with a prominent pathological condition. The prognosis of LGNPPA is usually excellent. Therefore, it is important for clinicians to scrutinize the lesion’s pathology to avoid unnecessary, disfiguring surgery.
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Affiliation(s)
- Hidenori Yokoi
- 1Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611 Japan
| | - Yuichi Terado
- 2Department of Pathology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611 Japan
| | - Masachika Fujiwara
- 2Department of Pathology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611 Japan
| | - Yuma Matsumoto
- 1Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611 Japan
| | - Tetsuya Ikeda
- 1Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611 Japan
| | - Koichiro Saito
- 1Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611 Japan
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Kakkar A, Sakthivel P, Mahajan S, Thakar A. Nasopharyngeal Papillary Adenocarcinoma as a Second Head and Neck Malignancy. Head Neck Pathol 2018; 13:699-704. [PMID: 29923095 PMCID: PMC6854352 DOI: 10.1007/s12105-018-0944-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 06/14/2018] [Indexed: 11/30/2022]
Abstract
Nasopharyngeal adenocarcinomas are rare tumours, and include neoplasms arising from the nasopharyngeal surface epithelium as well as those of minor salivary gland origin, each of which is distinct from the other. The former encompasses nasopharyngeal papillary adenocarcinoma (NPAC), also known as low grade NPAC and thyroid-like NPAC, an extremely unusual malignancy bearing histomorphological similarity to papillary thyroid carcinoma, and displaying indolent clinical behaviour. We report the case of a 41-year-old lady who developed NPAC as a second malignancy five-and-a-half years after being diagnosed and treated for a diffuse astrocytoma in the frontal lobe. In addition, we discuss the differential diagnosis, as well as raise certain pathogenetic considerations with regard to this unique neoplasm.
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Affiliation(s)
- Aanchal Kakkar
- Departments of Pathology, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Pirabu Sakthivel
- Departments of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Swati Mahajan
- Departments of Pathology, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Alok Thakar
- Departments of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
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Zhang WL, Ma S, Havrilla L, Cai L, Yu CQ, Shen S, Xu HT, Wang L, Yu JH, Lin XY, Wang E, Yang LH. Primary thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: A case report and literature review. Medicine (Baltimore) 2017; 96:e8851. [PMID: 29381996 PMCID: PMC5708995 DOI: 10.1097/md.0000000000008851] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
RATIONALE Primary thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is an extremely rare malignant nasopharyngeal tumor with features resembling papillary thyroid carcinoma including nuclear positive expression of thyroid transcription factor-1 (TTF-1). PATIENT CONCERNS A 64-year-old male presented with nasal bleeding and a foreign body sensation of the nasopharynx. Laryngoscopy revealed a 2.0-cm broad-based mass with a smooth surface on the posterior wall of the nasopharynx. A biopsy was obtained. DIAGNOSES Histopathologic examination demonstrated tumor cells arranged in both papillary and glandular architecture. The tumor cells express nuclear immunoreactivity for TTF-1. The diagnosis of TL-LGNPPA was made. INTERVENTIONS After the patient was diagnosed with TL-LGNPPA, he underwent complete surgical resection. OUTCOMES There was no recurrence or evidence of metastatic disease at the 12-month follow-up. LESSONS TL-LGNPPA is easy to misdiagnose as metastatic papillary thyroid carcinoma or other relative primary adenocarcinomas. It is important to have a broad differential diagnosis and know the key features of each entity because the prognosis and clinical treatment of each may differ.
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Affiliation(s)
- Wan-Lin Zhang
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
| | - Shuang Ma
- Department of Neurology, Sheng Jing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Lauren Havrilla
- Department of Pathology, Duke University Medical Center, Durham, NC
| | - Lin Cai
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
| | - Cheng-Qian Yu
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
| | - Shuai Shen
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
| | - Hong-Tao Xu
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
| | - Liang Wang
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
| | - Juan-Han Yu
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
| | - Xu-Yong Lin
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
| | - Endi Wang
- Department of Pathology, Duke University Medical Center, Durham, NC
| | - Lian-He Yang
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
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13
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Oide T, Kadosono O, Matsushima J, Wu D, Nagashima H, Saigusa H, Masunaga A, Nakatani Y, Hiroshima K. Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma with squamous differentiation: a novel histological finding. Hum Pathol 2017; 70:43-48. [PMID: 28601658 DOI: 10.1016/j.humpath.2017.05.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 05/25/2017] [Accepted: 05/26/2017] [Indexed: 10/19/2022]
Abstract
Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is an extremely rare neoplasm originating from the nasopharyngeal surface epithelium. Histopathologically, TL-LGNPPA is characterized by cuboidal/columnar tumor cells forming papillary fronds and thyroid transcription factor-1 (TTF-1) expression resembling papillary thyroid carcinoma. To date, the recorded histological features of TL-LGNPPA have been almost uniform, and the range of histological variations in this tumor type has not been sufficiently understood. Here, we report on a 68-year-old man with TL-LGNPPA. Microscopic examination of the resected tumor revealed findings typical of papillary adenocarcinoma of this type, and moreover, this case showed scattered squamous cell foci as a hitherto unreported finding. The squamous cells showed no obvious nuclear atypia or proliferating activity, and their presence was similar to the "squamous metaplasia" of papillary thyroid carcinoma. Immunohistochemically, p40 and TTF-1 coexpression was observed in the squamous cell nuclei, indicating their origin from the glandular tumor cells of TL-LGNPPA.
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Affiliation(s)
- Takashi Oide
- Department of Pathology, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo 276-8524, Japan.
| | - Osamu Kadosono
- Department of Otorhinolaryngology, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo 276-8524, Japan
| | - Jun Matsushima
- Department of Diagnostic Pathology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
| | - Di Wu
- Department of Pathology, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo 276-8524, Japan
| | - Hiroaki Nagashima
- Department of Otorhinolaryngology, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo 276-8524, Japan
| | - Hideto Saigusa
- Department of Otorhinolaryngology, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo 276-8524, Japan
| | - Atsuko Masunaga
- Department of Pathology, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo 276-8524, Japan
| | - Yukio Nakatani
- Department of Diagnostic Pathology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; Department of Pathology, Chiba University Hospital, Chiba 260-8677, Japan
| | - Kenzo Hiroshima
- Department of Pathology, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo 276-8524, Japan
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14
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Ozturk K, Midilli R, Veral A, Ertan Y, Karci B. Primary thyroid-like papillary adenocarcinoma of the nasal septum: a case report. EAR, NOSE & THROAT JOURNAL 2016; 94:E19-21. [PMID: 25651353 DOI: 10.1177/014556131509400213] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Primary thyroid-like papillary adenocarcinomas are extremely rare neoplasms that generally originate in the nasopharynx. We report the case of a 24-year-old woman who was diagnosed with a thyroid-like papillary adenocarcinoma that originated in the nasal septum. The tumor was surgically removed, and the patient showed no evidence of local recurrence during 4 years of follow-up.
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Affiliation(s)
- Kerem Ozturk
- Department of Otolaryngology, Ege Universitesi Tip Fakultesi Kulak Burun Bogaz Anabilim Dali, 35100, Bornova, Izmir, Turkey.
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Horino T, Ichii O, Hamada-Ode K, Matsumoto T, Shimamura Y, Inoue K, Terada Y. Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: A case report. Mol Clin Oncol 2016; 5:693-696. [PMID: 28105348 PMCID: PMC5228490 DOI: 10.3892/mco.2016.1056] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 09/14/2016] [Indexed: 12/30/2022] Open
Abstract
Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is a rare neoplasm characterized by morphological analogy to papillary thyroid carcinoma and abnormal expression of thyroid transcription factor-1 (TTF-1). We herein report a rare case of TL-LGNPPA with a review of its clinical, morphological and immunohistochemical characteristics. The patient was a 25-year-old Japanese woman complaining of a 2-year history of fever of unknown origin. There were no remarkable physical findings and the laboratory tests, including C-reactive protein levels, were normal. Laryngoscopy, magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography identified a pedunculated mass at the roof of the nasopharynx. Histologically, the tumour exhibited papillary growth of cuboidal or columnar epithelium. Tubular architecture and a spindle cell component were also observed focally. Some tumour cells exhibited intranuclear cytoplasmic inclusions. Immunohistochemically, the neoplastic cells were positive for TTF-1, cytokeratin 7 and vimentin, but were negative for thyroglobulin. The Ki-67 labelling index (MIB-1 index) reached 5% in the most concentrated spot. The patient had neither local recurrence nor distant metastasis 3 years after removal of the tumour. In conclusion, TL-LGNPPA should be included it in the differential diagnosis of fever of unknown origin.
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Affiliation(s)
- Taro Horino
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Nankoku, Kochi 783-8505, Japan
| | - Osamu Ichii
- Laboratory of Anatomy, Department of Biomedical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Kazu Hamada-Ode
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Nankoku, Kochi 783-8505, Japan
| | - Tatsuki Matsumoto
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Nankoku, Kochi 783-8505, Japan
| | - Yoshiko Shimamura
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Nankoku, Kochi 783-8505, Japan
| | - Kosuke Inoue
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Nankoku, Kochi 783-8505, Japan
| | - Yoshio Terada
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Nankoku, Kochi 783-8505, Japan
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Li M, Wei J, Yao X, Wang C. Clinicopathological Features of Low-Grade Thyroid-like Nasopharyngeal Papillary Adenocarcinoma. Cancer Res Treat 2016; 49:213-218. [PMID: 27384157 PMCID: PMC5266392 DOI: 10.4143/crt.2016.195] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 06/07/2016] [Indexed: 01/01/2023] Open
Abstract
PURPOSE Primary low-grade thyroid-like papillary adenocarcinomas are extremely rare neoplasms that generally originate in the nasopharynx. Here, we describe a novel case of a 15-year-old Chinese girl who was diagnosed with low-grade thyroid-like papillary adenocarcinoma, including a brief review of the literature to reveal the clinicopathological features of low-grade thyroid-like nasopharyngeal papillary adenocarcinoma. MATERIALS AND METHODS Immunohistochemistry was used to evaluate the expression of pan-cytokeratin (CKpan), cytokeratin (CK) 7, thyroid transcription factor 1 (TTF-1), vimentin, epithelial membrane antigen (EMA), thyroglobulin, CD15, S100, P40, CK20, CDX-2, glial fibrillary acidic protein (GFAP), and Ki-67. Additionally, in situ hybridization investigation was utilized to identify the presence of small Epstein-Barr virus (EBV)-encoded RNA. RESULTS Histopathological analysis revealed florid proliferation of papillary structures lined by columnar epithelial cells with fibrovascular cores. Immunohistochemically, the neoplastic cells were positive for CKpan, CK7, TTF-1, vimentin, and EMA, but negative for thyroglobulin, CD15, S100, P40, CK20, CDX-2, and GFAP. The Ki-67-labeling index reached 5% in the most concentrated spot. In situ hybridization for EBV was negative. CONCLUSION Due to the distinct rarity of low-grade thyroid-like papillary adenocarcinomaswith a favorable clinical outcome, a nationwide effort to raise public awareness of this neoplasm is required.
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Affiliation(s)
- Minhua Li
- Department of Pathology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China
| | - Jiangguo Wei
- Department of Pathology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China
| | - Xiaofei Yao
- Department of Pathology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China
| | - Cheng Wang
- Department of Pathology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China
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Tian L, Jiao Y, Liu M, Li M, Yao H. Ectopic thyroid papillary carcinoma of nasopharynx associated with adenoid hypertrophy: an unusual presentation. Head Face Med 2014; 10:40. [PMID: 25238975 PMCID: PMC4176853 DOI: 10.1186/1746-160x-10-40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 09/18/2014] [Indexed: 01/31/2023] Open
Abstract
Ectopic thyroid tissue of nasopharynx is an uncommon phenomenon and papillary thyroid carcinoma arising from the tissue is extremely rare. The authors report a rare case of 16-year-old girl with papillary thyroid carcinoma of nasopharynx. Clinicians were ever confused by adenoid hypertrophy and solved the diagnostic dilemma by adequate examinations. In the case, we mainly emphasize that surgeons should be aware of and actively consider such a possibility of ectopic papillary thyroid carcinoma of nasopharynx in children and adolescents with long-term nasal obstruction, even if thyroid carcinoma is a rare tumor.
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Affiliation(s)
| | | | | | | | - Hongchao Yao
- Department of Otolaryngology, Head and Neck Surgery, The Second Affiliated Hospital, Harbin Medical University, Harbin, China.
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Oishi N, Kondo T, Nakazawa T, Mochizuki K, Kasai K, Inoue T, Yamamoto T, Watanabe H, Hatsushika K, Masuyama K, Katoh R. Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: case report and literature review. Pathol Res Pract 2014; 210:1142-5. [PMID: 24893893 DOI: 10.1016/j.prp.2014.04.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 04/21/2014] [Accepted: 04/28/2014] [Indexed: 02/02/2023]
Abstract
Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is an extremely rare neoplasm characterized by morphological analogy to papillary thyroid carcinoma and abnormal expression of thyroid transcription factor-1 (TTF-1). Here we report a novel case of TL-LGNPPA with literature review. The patient was a 43-year-old woman complaining of nasal obstruction. Laryngoscopic study and computed tomography identified a pedunculated mass located on the posterior edge of the left nasal septum. Histologically, the tumor consisted of papillary growth of cuboidal or columnar epithelium. Tubular architecture and a spindle cell component were also observed focally. Some tumor cells exhibited intra-nuclear cytoplasmic inclusions. Immunohistochemically, the neoplastic cells were positive for pancytokeratin (AE1/AE3), CK7, CK19, TTF-1, vimentin and HBME1, but negative for thyroglobulin, Pax8 and CK5/6. Ki67-labeling index reached 5% in the most concentrated spot. Despite the morphological and immunohistochemical similarity to papillary thyroid carcinoma, no BRAF V600E mutation was detected by mutation-specific immunohistochemistry. The patient had neither local recurrence nor distant metastasis 19 months after removal of the tumor.
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Affiliation(s)
- Naoki Oishi
- Department of Pathology, School of Medicine, University of Yamanashi, Japan
| | - Tetsuo Kondo
- Department of Pathology, School of Medicine, University of Yamanashi, Japan.
| | - Tadao Nakazawa
- Department of Pathology, School of Medicine, University of Yamanashi, Japan
| | - Kunio Mochizuki
- Department of Pathology, School of Medicine, University of Yamanashi, Japan
| | - Kazunari Kasai
- Department of Pathology, School of Medicine, University of Yamanashi, Japan
| | - Tomohiro Inoue
- Department of Pathology, School of Medicine, University of Yamanashi, Japan
| | - Takanori Yamamoto
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Yamanashi, Japan
| | - Hiroyuki Watanabe
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Yamanashi, Japan
| | - Kyousuke Hatsushika
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Yamanashi, Japan
| | - Keisuke Masuyama
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Yamanashi, Japan
| | - Ryohei Katoh
- Department of Pathology, School of Medicine, University of Yamanashi, Japan
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Chu YT, Yue CT. Nasopharyngeal papillary adenocarcinoma: A case report and clinicopathologic review. Tzu Chi Med J 2012. [DOI: 10.1016/j.tcmj.2011.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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