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Chen W, Zhao J. Clinicopathologic features of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma. Asian J Surg 2024; 47:2433-2434. [PMID: 38302361 DOI: 10.1016/j.asjsur.2024.01.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/19/2024] [Indexed: 02/03/2024] Open
Affiliation(s)
- Weiwei Chen
- Department of Pathology, Affiliated Yiwu Hospital of Hangzhou Medical College, No.20 Jubao Road, Futian Street, Yiwu, Zhejiang, 322000, PR China.
| | - Jing Zhao
- Department of Ophthalmology, Yiwu Hospital of Traditional Chinese Medicine, No. 266, Xuefeng West Road, Yiwu, Zhejiang, 322000, PR China
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2
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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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Hu H, Long L, Fan X, He J. Clinicopathologic characteristics of low-grade thyroid-like nasopharyngeal papillary adenocarcinoma: a case report. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2022; 15:431-434. [PMID: 36381418 PMCID: PMC9638840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/15/2022] [Indexed: 06/16/2023]
Abstract
Low-grade thyroid-like nasopharyngeal papillary adenocarcinoma is a rare malignant tumor characterized by morphologic analogy to papillary thyroid carcinoma and aberrant thyroid transcription factor-1 (TTF-1) expression. To date, a limited number of cases have been reported in the literature. We report a case of a 20-year-old Chinese male patient with complaints of headaches and nosebleeds for 5 months. The histopathologic examination showed thyroid-like low-grade nasopharyngeal papillary adenocarcinoma that was confirmed by immunohistochemical staining. The patient was treated with macroscopic complete resection without adjuvant therapy. The epidemiologic characteristics and clinical and pathologic features of the disease are summarized. In addition, we summarize the treatments used previously. In general, TL-LGNPPA is a very rare low-grade adenocarcinoma with aberrant expression of TTF-1, and its diagnosis depends on morphology and immunophenotype. The prognosis is good.
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Affiliation(s)
- Haoyue Hu
- Department of Medical Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Medicine School of University of Electronic Science and TechnologyChengdu 610041, China
| | - Lang Long
- Department of Pediatric Respiratory and Neurology, The Central Hospital of Enshi Tujia and Miao Autonomous PrefectureEnshi, China
| | - Xue Fan
- Department of Medical Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Medicine School of University of Electronic Science and TechnologyChengdu 610041, China
| | - Jun He
- Department of Oncology, The Third Hospital of Mianyang (Sichuan Mental Health Center)Mianyang, China
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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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Jibril Y, Salisu A, Mustapha M, Oluwafemi OA. A rare case of low-grade nasopharyngeal papillary adenocarcinoma in a young adult woman: A case report from a tertiary hospital in Northwestern Nigeria. JOURNAL OF WEST AFRICAN COLLEGE OF SURGEONS 2022; 12:107-110. [PMID: 36203914 PMCID: PMC9531729 DOI: 10.4103/jwas.jwas_45_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/20/2022] [Indexed: 11/04/2022]
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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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Kuczkiewicz-Siemion O, Wnuk E, Durzyńska M. Cribriform adenocarcinoma of minor salivary glands presented as a nasopharyngeal tumor: A case report highlighting the significance of cytology. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:e91-e95. [PMID: 34753697 DOI: 10.1016/j.oooo.2021.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 07/29/2021] [Accepted: 08/22/2021] [Indexed: 11/16/2022]
Abstract
Cribriform adenocarcinoma of minor salivary gland (CAMSG) is a rare malignancy presenting cytologic features resembling papillary thyroid carcinoma, localized in the oral cavity and oropharynx. Although cervical lymph node (LN) metastasis is a frequent manifestation of CMSG, there are few publications evaluating its cytology. The aim of this report was to present a CAMSG in an unusual location in the light of cytologic features, thereby enriching the spectrum of fine-needle aspiration biopsy (FNAB) differential diagnosis. We report a case of a 76-year-old woman presenting an enlarged submandibular LN on physical examination. Computed tomography revealed a submucosal lesion situated predominantly in the nasopharynx. FNAB and subsequently an open biopsy of submandibular LN were conducted. In cytologic smear cribriform, dense clusters of monomorphic round-oval tumor cells with scant cytoplasm were observed. Histologically, the tumor was composed of oval, overlapping cells with bright nuclear chromatin and nuclear grooves forming cribriform, papillary, and solid structures. Immunohistochemistry panel revealed the following: TTF-1 (-), thyroglobulin (-), S100 (+), p63 (+), Gal-3 (+), and CK19 (+) focally. The diagnosis of CAMSG should be considered when dealing with nasopharyngeal mass. Commonly, nodal metastases are observed in this tumor; therefore, appropriate evaluation of cytologic smear is crucial for patient management.
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Affiliation(s)
- Olga Kuczkiewicz-Siemion
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
| | - Emilia Wnuk
- Second Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland
| | - Monika Durzyńska
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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Lai Y, Li W, Zhai C, Song X, Yang J, Sun X, Wang D. Low-Grade Nasopharyngeal Papillary Adenocarcinoma: A Review of 28 Patients in a Single Institution. Cancer Manag Res 2021; 13:1271-1278. [PMID: 33603472 PMCID: PMC7882443 DOI: 10.2147/cmar.s288007] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/24/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Low-grade nasopharyngeal papillary adenocarcinoma (LGNPPA) is a rare nasopharyngeal tumor. This study aimed to analyze the clinical and histopathological features of the disease, and to share our experience of its treatment. Patients and Methods We collected demographic data, clinical symptoms, tumor location, pathological features, immunohistochemical results, treatments, and outcomes of 28 patients with pathologically confirmed LGNPPA between 2009 and 2019. Results The median age of the 28 patients was 41.5 years, with a female: male ratio of 1.5:1 (17 females, 11 males). The most common symptom was blood-stained rhinorrhea. The neoplasms were located on the roof of the nasopharynx (RON) in 13 patients, the posterior margin of the nasal septum (PMONP) in 12 patients, the lateral wall of the nasopharynx in one case, and both the RON and PMONP in two patients. Fourteen patients were diagnosed with thyroid-like LGNPPA. Immunohistochemically, the tumors were uniformly positive for cytokeratin 7, cytokeratin 8, vimentin, epithelial membrane antigen, and pan-cytokeratin, and negative for thyroglobulin. Twenty-three patients underwent pure endoscopic surgery, three patients underwent preoperative radiotherapy, and two patients underwent radiotherapy postoperatively. All patients were alive without evidence of lymphatic or distant metastases in the follow-up period (range: 7 to 121 months). Two patients (7%, 2/28) experienced disease recurrence. Conclusion LGNPPA is an indolent tumor with an excellent prognosis. Endonasal endoscopic excision was an effective treatment. It is important to distinguish thyroid-like LGNPPA from metastatic papillary thyroid carcinoma because these diseases have similar microscopic features but different prognoses.
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Affiliation(s)
- Yuting Lai
- Department of Otolaryngology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, People's Republic of China
| | - Wanpeng Li
- Department of Otolaryngology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, People's Republic of China
| | - Changwen Zhai
- Department of Clinical Pathology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, People's Republic of China
| | - Xiaole Song
- Department of Otolaryngology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, People's Republic of China
| | - Jingyi Yang
- Department of Otolaryngology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, People's Republic of China
| | - Xicai Sun
- Department of Otolaryngology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, People's Republic of China
| | - Dehui Wang
- Department of Otolaryngology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, People's Republic of China
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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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10
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Bubola J, Antonescu CR, Weinreb I, Swanson D, De Almeida JR, MacMillan CM, Dickson BC. A novel low-grade nasopharyngeal adenocarcinoma characterized by a GOLGB1-BRAF fusion gene. Genes Chromosomes Cancer 2020; 60:49-53. [PMID: 32951290 DOI: 10.1002/gcc.22897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 11/10/2022] Open
Abstract
Nasopharyngeal adenocarcinoma is a rare malignancy that is classified into conventional/surface- and salivary-types. Herein we report the case of a 52-year-old male who presented with a right nasopharyngeal mass and right-sided hearing loss. Diagnostic imaging revealed a circumscribed 1.7 cm mass centred in the right antero-lateral aspect of the nasopharynx. A biopsy showed a gland-forming neoplasm that was in continuity with the surface epithelium. The tumor exhibited a nested to micro-papillary architecture, with mild cytologic atypia. Immunohistochemistry demonstrated diffuse staining for CK7, SOX10, and p16; the abluminal layer was highlighted by CK5 and p63, while the luminal cells expressed CD117. The tumor was not amenable to subclassification and was diagnosed as a low-grade nasopharyngeal adenocarcinoma, not otherwise specified (NOS). Subsequent RNA sequencing was performed which identified a novel GOLGB1-BRAF fusion product. Based on its unique morphology and molecular findings, this is presumed to represent a novel subtype of nasopharyngeal adenocarcinoma. In addition to being of diagnostic relevance, this fusion may ultimately represent a potential therapeutic target.
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Affiliation(s)
- Justin Bubola
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.,Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Cristina R Antonescu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ilan Weinreb
- Department of Pathology, University Health Network, Toronto, Ontario, Canada
| | - David Swanson
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - John R De Almeida
- Department of Otolaryngology Head and Neck Surgery, Department of Surgical Oncology, University Health Network, Toronto, Ontario, Canada
| | - Christina M MacMillan
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Brendan C Dickson
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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11
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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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12
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Maocai L, Fuxing L, Lianqing L, Lili G, WenChao D, ShouZhou L. Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: A case report. Medicine (Baltimore) 2020; 99:e21599. [PMID: 32872013 PMCID: PMC7437768 DOI: 10.1097/md.0000000000021599] [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] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is a rare neoplasm characterized by morphological analogy to papillary thyroid carcinoma and the abnormal expression of thyroid transcription factor-1 (TTF-1). We herein report a rare case of TL-LGNPPA with a review of its clinical and morphological characteristics and the treatment provided. PATIENT CONCERNS AND DIAGNOSIS The patient was a 50-year-old Chinese woman with the complaint of a three-year history of phlegm with blood with pharyngeal discomfort. There were no remarkable physical findings, and the laboratory tests were normal. Laryngoscopy and nasal computed tomography identified a mass at the posterior end of the nasal septum. Histologically, the tumor exhibited an oval papillary growth. Immunohistochemically, the neoplastic cells were positive for TTF-1, vimentin, cytokeratin 7, and cytokeratin 19. Pathological examination indicated a thyroid-like low-grade nasopharyngeal papillary adenocarcinoma. INTERVENTION The neoplasm was completely resected without any complication. OUTCOMES The patient had neither local recurrence nor distant metastasis 1 year after the removal of the tumor. CONCLUSION Although TL-LGNPPA is a malignant tumor, complete surgical resection is an effective treatment.
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Clinicopathologic Characteristics of Thyroid-like Low-grade Nasopharyngeal Papillary Adenocarcinoma: A Case Report. Appl Immunohistochem Mol Morphol 2020; 27:e81-e84. [PMID: 29494399 DOI: 10.1097/pai.0000000000000545] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is an extremely rare neoplasm. It morphologically resembles papillary thyroid carcinoma and is immunochemically positive for thyroid transcription factor 1. Herein, we reported a case of TL-LGNPPA in a female patient of 35 years old. She felt pharyngeal foreign body sensation of unknown cause and subsequently developed dyspnea after activities. Nasopharyngeal plain computerized tomography showed no abnormalities, but laryngoscopy showed a peanut-sized smooth neoplasm with a pedicel at the posterior edge of the nasal septum. The mass was completely resected by nasopharyngoscopy. Histologic examination showed the tumor was composed of papillary configuration and tubular glands; each papilla was covered with cuboidal or columnar epithelial cells; tubular architecture and spindle cell component were also observed; some tumor cells had psammoma bodies. Immunohistochemically, tumor cells were positive for CKpan, CK7, CK19, VIM, and thyroid transcription factor 1, but negative for thyroglobulin, CK20, S-100, P63, P40, smooth muscle actin, CDX-2, and glial fibrillary acidic protein. This patient was diagnosed with TL-LGNPPA and followed up for 16 months, and metastasis and recurrence were not observed.
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Lee JH, Kown JH. Nasopharyngeal Papillary Adenocarcinoma: A Cotton Swab Appearance on Computer Tomography. EAR, NOSE & THROAT JOURNAL 2020; 101:NP28-NP30. [PMID: 32697110 DOI: 10.1177/0145561320942684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Jae-Hoon Lee
- Department of Otolaryngology, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Jeonbuk, Republic of Korea
| | - Jung-Hun Kown
- Department of Otolaryngology, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Jeonbuk, Republic of Korea
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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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Roncaroli F, Chatterjee D, Giannini C, Pereira M, La Rosa S, Brouland JP, Gnanalingham K, Galli C, Fernandes B, Lania A, Radotra B. Primary papillary epithelial tumour of the sella: expanding the spectrum of TTF-1-positive sellar lesions. Neuropathol Appl Neurobiol 2020; 46:493-505. [PMID: 32311761 DOI: 10.1111/nan.12622] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/30/2020] [Accepted: 04/09/2020] [Indexed: 12/11/2022]
Abstract
AIM To describe four novel primary epithelial tumours of the sella with papillary architecture and Thyroid Transcription Factor 1 (TTF-1) expression. METHODS Paraffin-embedded tissue from the four cases and recurrence of patient 1 was investigated with haematoxylin-eosin, special histochemical stains, immunohistochemistry with a broad panel of antibodies and next-generation sequencing. The ultrastructure of one tumour was studied in tissue retrieved from paraffin. RESULTS The lesions occurred in three females aged 20, 26 and 42 years and a male aged 49 years. They presented with signs and symptoms secondary to pituitary stalk compression. Preoperative neuroimaging documented mixed solid and cystic, enhancing sellar masses with suprasellar extension. Histologically, the tumours showed thin papillae lined by a single layer of cytokeratin and TTF-1-positive cuboidal and cylindrical cells with mildly atypical nucleus. Next-generation sequencing performed in three cases did not identify any mutations. The main differential diagnosis included metastasis from lung or thyroid carcinoma, extraventricular choroid plexus papilloma and sellar ependymoma. CONCLUSION We suggest the descriptive term of primary papillary epithelial tumour of the sella (PPETS) for this entity and propose that it could represent the intracranial equivalent of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma. The cell of origin of PPETS remains undetermined although the intense and ubiquitous expression of TTF-1 may suggest a derivation from the infundibulum or ventricular recess. Our study expands the spectrum of sellar TTF-1-positive tumour and challenges the view that they all derive from pituicytes.
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Affiliation(s)
- F Roncaroli
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biology, University of Manchester, Manchester, UK
| | - D Chatterjee
- Deparment of Histopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - C Giannini
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, USA.,Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - M Pereira
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Division of Evolution and Genomic Science, University of Manchester, Manchester, UK
| | - S La Rosa
- Institute of Pathology, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - J P Brouland
- Institute of Pathology, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - K Gnanalingham
- Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal Foundation Trust, Salford, Manchester, UK
| | - C Galli
- Department of Histopathology, Humanitas University, Milan, Italy
| | - B Fernandes
- Department of Histopathology, Humanitas University, Milan, Italy
| | - A Lania
- Department of Endocrinology, Humanitas University, Milan, Italy
| | - B Radotra
- Deparment of Histopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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17
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Thyroid-Like Low-Grade Nasopharyngeal Papillary Adenocarcinoma with Biphasic Histology. Case Rep Pathol 2020; 2020:3275916. [PMID: 32015924 PMCID: PMC6988662 DOI: 10.1155/2020/3275916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/23/2019] [Indexed: 11/17/2022] Open
Abstract
Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is a rare primary adenocarcinoma of nasopharynx. The immunohistochemical pattern of this tumor is similar to that of papillary thyroid carcinoma making this neoplasm a challenging diagnosis. A case of TL-LGNPPA with biphasic morphology is presented. The removed tumor from the nasopharynx exhibited a polypoid appearance. Microscopically, it was composed of papillary structures admixed with a few solid areas of spindle cells. The papillae were lined by columnar epithelium. Both the epithelium and the spindle cells were strongly positive for TTF-1 and CK19 and negative for CK5/6, S-100, and thyroglobulin. Cellular atypia, necrosis, and high mitotic rate were absent. Ki67 was less than 2% in the neoplastic cells. No local recurrence or distant metastasis was reported after 12 months of follow-up. Caution should be taken to differentiate TL-LGPPA from other TTF-1-positive neoplasms, especially papillary thyroid carcinoma, as the prognosis for these two tumors is entirely different.
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18
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Zhong QY, Sun Q, Liu ZH. Endoscopic Low-Temperature Plasma Radiofrequency Ablation for Primary Thyroid-Like Low-Grade Nasopharyngeal Papillary Adenocarcinoma. EAR, NOSE & THROAT JOURNAL 2019; 100:563-564. [PMID: 31619076 DOI: 10.1177/0145561319880976] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Qing-Yao Zhong
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of 66367Zunyi Medical University, Zunyi, Guizhou, China
| | - Qiang Sun
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of 66367Zunyi Medical University, Zunyi, Guizhou, China
| | - Zhao-Hui Liu
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of 66367Zunyi Medical University, Zunyi, Guizhou, China
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19
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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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20
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Min HJ, Kim KS. Progressive Bilateral Nasal Obstruction Due to Nasopharyngeal Mass. JAMA Otolaryngol Head Neck Surg 2019; 145:971-972. [PMID: 31415072 DOI: 10.1001/jamaoto.2019.2254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Hyun Jin Min
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Kyung Soo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
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21
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Sourati A, Malekzadeh M, Rakhshan A. Thyroid-like low-grade papillary adenocarcinoma of nasopharynx. BMJ Case Rep 2019; 12:12/6/e226949. [PMID: 31177192 DOI: 10.1136/bcr-2018-226949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We report a 35-year-old woman with complaints of nasal obstruction and mild post-nasal drip for 6 months. She did not improve with medical treatment. Clinical examination had no positive finding. She was evaluated with a CT scan and MRI that revealed a polypoid mass lesion in nasopharynx without any adhesion to adjacent tissue. Endoscopic examination of nasopharynx revealed an exophytic nasopharyngeal mass in anterior wall of nasopharynx that complete macroscopic transnasal endoscopic resection was performed. The histopathological examination reported thyroid-like low-grade nasopharyngeal papillary adenocarcinoma that was confirmed on immunohistochemical staining. After complete macroscopic resection of the mass, patient was regularly followed-up for 6 years and there was no evidence of recurrence. This example has the educational tips of the optimal therapeutic strategies for primary nasopharyngeal adenocarcinomas with long follow-up.
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Affiliation(s)
- Ainaz Sourati
- Radiation Oncology of Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mona Malekzadeh
- Department of Radiation-Oncology, Shohada-e Tajrish Hospital, Tehran, Iran
| | - Azadeh Rakhshan
- Department of Pathology, Shohada-e Tajrish Hospital, Tehran, Iran
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22
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Demyashkin GA, Kastyro IV, Sidorin AV, Borisov YS. [The specific immunophenotypic features of nasopharyngeal carcinoma]. Vestn Otorinolaringol 2018; 83:40-44. [PMID: 30412174 DOI: 10.17116/otorino20188305140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We have undertaken the retrospective analysis of the medical histories of 119 patients presenting with nasopharyngeal carcinoma (NPC) and the biopsy specimens obtained from them; the wereinvestigated with the use of the histological (staining of the micropreparations with hematoxylin and eosin) and immunehistochemical (monoclonal murine antibodies against Pan-cytokeratin, CK 5/6, EBV, CK7, CK19, p16) techniques. The study has demonstrated the presence of non-differentiated nasopharyngeal carcinoma in 97 patients, diffuse large-cell B-lymphoma in 18 ones, melanoma of the nasopharyngeal mucous membrane in 2, and nasopharyngeal rhabdosarcoma in 1 patient. The immunohistochemical study revealed co-expression of the markers of Epstein-Barr virus, Pan-cytokeratin, and CK 5/6 in the non-differentiated nasopharyngeal carcinoma .
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Affiliation(s)
- G A Demyashkin
- The Pathologo-Anatomical Department with Cytological Laboratory, Research Clinical Centre of 'RZhD' open joint stock company, Moscow, Russia; Academician A.I. Strukov Pathologo-Anatomical Department, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
| | - I V Kastyro
- Department of Otorhinolaryngology, Medical Institute of Russian University of People's Friendship Moscow, Russia
| | - A V Sidorin
- The Pathologo-Anatomical Department, A.F. Tsyba Medical Radiological Research Centre - a branch of the Federal state budgetary institution 'National Medical Research Radiological Centre', Ministry of Health of the Russian Federation, Obninsk, Kaluzhskaya region, Russia
| | - Ya S Borisov
- Faculty of General Medicine, N.I.Pirogov Russian National Research Medical University, Department of Otorhinolaryngology, Ministry of Health of the Russian Federation, Moscow, Russia
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23
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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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24
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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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25
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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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