Pathologic Features

Fig. 1.20. Nasopharyngeal carcinoma. a Islands of poorly differentiated carcinoma beneath the surface epithelium, with dense lymphocytic infiltration of the stroma. b In situ hybridisation reveals Epstein-Barr virus RNA transcripts in the nuclei of all tumour cells

Fig. 1.20. Nasopharyngeal carcinoma. a Islands of poorly differentiated carcinoma beneath the surface epithelium, with dense lymphocytic infiltration of the stroma. b In situ hybridisation reveals Epstein-Barr virus RNA transcripts in the nuclei of all tumour cells

carcinomatous components, and the involvement of the surface epithelium exhibiting atypical hyperplasia, carcinoma in situ, or invasive SCC.

The presence of mucin in true glandular spaces helps to distinguish ASCs from adenoid SCCs.

Conventional SCCs invading or entrapping the normal salivary or mucoserous glands can be confused with ASC, especially in small biopsy specimens. In such cases, preservation of lobular gland architecture and lack of significant atypia are observed, helping to distinguish conventional SCCs from ASCs.

Finally, ASCs must be differentiated from necrotising sialometaplasia, which is a benign condition. The histo-pathologic features suggesting the diagnosis of necrotis-ing sialometaplasia are: surface ulceration, localisation in minor salivary glands, lobular architecture, partial necrosis of the salivary gland, and squamous metaplasia of the salivary ducts.

The ASC has a more aggressive course than the conventional SCC [131, 258, 313], with a tendency toward early lymph node metastases, frequent local recurrences, and occasional dissemination [192]. The reported 5-year survival rate is between 13 and 25% [124, 131, 192].

The treatment of choice is radical surgical excision. Irradiation alone has had poor results [124, 192, 313]. Some reports indicate that radical surgery combined with irradiation may improve the survival rate [6].

ICD-O:8082/3

Lymphoepithelial carcinoma (LEC) is a poorly differentiated SCC or undifferentiated carcinoma, associ ated with dense lymphocytic stromal infiltration. It is morphologically indistinguishable from nasopharyn-geal carcinoma type 3 (WHO classification) [381]. It was originally described in the nasopharynx in 1921 by Regaud and Reverchon [294], and independently by Schmincke [315]. Synonyms for LEC include lympho-epithelioma, nasopharyngeal-type carcinoma, Regaud and Schmincke-type lymphoepithelioma, and undif-ferentiated carcinoma. The specific features of the na-sopharyngeal carcinoma are extensively discussed in Chap. 6.

Apart from the nasopharynx, it rarely occurs in other locations in the head and neck, such as the oropharynx, salivary glands, tonsils, tongue, soft palate, uvula, floor of the mouth, sinonasal tract, l arynx and hy-popharynx [67, 93, 120, 227, 392], as well as elsewhere in the body including the lung, urinary bladder, uterine cervix, breast, skin and stomach [113].

Mole Removal

Mole Removal

Moles, warts, and other unsightly irregularities of the skin can be bothersome and even embarrassing. They can be removed naturally... Removing Warts and Moles Naturally! If you have moles, warts, and other skin irregularities that you cannot cover up affecting the way you look, you can have them removed. Doctors can be extremely expensive. Learn the natural ways you can remove these irregularities in the comfort of your own home.

Get My Free Ebook


Post a comment