Reticular and myxoid non-keratinizing nasopharyngeal carcinoma: an unusual case mimicking a salivary gland carcinoma

Amyloid and hyaline globules in undifferentiated nasopharyngeal carcinoma

We characterize the clinicopathological features of two patients (one 38 year old woman and one 42 year old man, both of Chinese ethnicity) with Epstein Barr Virus positive non-keratinizing nasopharyngeal carcinoma from an endemic region with prominent presence of amyloid and one case with both amyloid and abundant intracytoplasmic hyaline globules. The amyloid material was positive for Congo red and showed apple green birefringence when examined under polarized light. The amyloid was immunoreactive for cytokeratins and was located both intra- and extracellularly. Frequently the amyloid had a light microscopical spherical appearance and displayed peripheral radiating fibrils from a central homogenous core. One of the patients had a unique presentation of nasopharyngeal carcinoma with perceived hemoptysis and coughing up two pieces of tumor tissue. In reality, the nasopharyngeal tumor was polypoid and the two fragments were pinched of from the main tumor mass.

EBV-Associated Non-keratinizing Nasopharyngeal Carcinoma with Prominent Spindled Cell and Whorling Patterns: A Previously Unreported Histological Variant in a Patient Presenting with Dermatomyositis

A case of non-keratinizing, EBV-positive (chromogenic EBER-in situ hybridization), carcinoma with a hitherto undescribed nodular whorling architecture is presented. The patient is a 55 year old male with 2 months history of dermatomyositis who was diagnosed with T1N0M0 non-keratinizing nasopharyngeal carcinoma. The patient received radiotherapy with complete response. The tumor cells predominantly displayed spindle cell morphology, strongly expressed low-molecular weight cytokeratins (AE1-3), p63 and p40. There was no evidence of recurrence or disease progression on follow-up after 16 months which included post treatment biopsy, MRI and PET-CT scans.

Non-Keratinizing Nasopharyngeal Carcinoma with Adenomatous Differentiation

A case of non-keratinizing, EBV-positive (EBER-in situ hybridization), carcinoma with adenomatous differentiation is presented. The patient is a 40 year old male with T2N2M0 disease who received standard combined chemo- and radiotherapy with complete resolution of all tumor. The tumor cells were strongly positive for low-molecular weight cytokeratins (AE1-3) and scattered cells expressed cytokeratin 20. No expression of cytokeratin 5/6, 7, p63, TTF-1, CDX2 or androgen receptor was detected. There was no evidence of recurrence or disease progression on follow-up after 19 months, which included post treatment MRI and PET-CT scans.

Low-grade nasopharyngeal papillary adenocarcinoma: a case report and review of the literature

Low-grade nasopharyngeal papillary adenocarcinoma is an extremely rare tumor, with only a limited number of cases reported in the literature. Some published studies have paid more attention to the clinicopathological features of nasopharyngeal adenocarcinoma, while little effort has been made to study the optimal therapeutic strategies. We report about a woman diagnosed with low-grade nasopharyngeal papillary adenocarcinoma. She received the treatment approach that combined transnasal endoscopic surgery to remove the lesion with postoperative radiotherapy for nasal cavity. There was no evidence of recurrence after 4 months of surgery, and further follow-up is being continued. Through this example, we wanted to explore the optimal therapeutic strategies for primary nasopharyngeal adenocarcinomas.

Myoepithelial Carcinoma of the Nasopharynx: Report of a Rare Case and a Review of the Literature

Salivary gland carcinomas are very rare in the nasopharynx, with the most frequent histologic types being adenoid cystic carcinoma, mucoepidermoid carcinoma and adenocarcinoma, not otherwise specified. Myoepithelial carcinoma (MECA) is a rare tumor of the salivary glands, and there are only three previously reported cases of nasopharyngeal MECA. The case presented is the fourth reported case of MECA in the nasopharynx. Due to the morphologic heterogeneity of MECA, immunohistochemistry is indispensable in ascertaining the diagnosis. MECA is a locally aggressive tumor, but the long-term prognosis of this tumor in the nasopharynx remains uncertain. In our case the tumor was unresectable and the patient was given chemo-radiotherapy. Despite this, residual tumor was seen on nasoscopy 5 months after initial diagnosis and was documented on a re-biopsy which displayed the same histomorphologic features as the original tumor.