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A Subset of Sinonasal Non-Intestinal Type Adenocarcinomas are Truly Seromucinous Adenocarcinomas: A Morphologic and Immunophenotypic Assessment and Description of a Novel Pitfall
- Source :
- Head and neck pathology. 9(4)
- Publication Year :
- 2014
-
Abstract
- While sinonasal intestinal type adenocarcinoma (ITAC) is defined by an intestinal phenotype, non-intestinal type adenocarcinoma (non-ITAC) is traditionally viewed as a diagnosis of exclusion, despite previous implication of a seromucinous phenotype and similarity to sinonasal seromucinous hamartomas (SSH). We performed a comparison of clinicopathologic and immunophenotypic features of ITAC, non-ITAC and SSH using traditional discriminatory markers and new markers of seromucinous differentiation. Twenty-three non-ITAC, 17 ITAC, and 5 SSH were retrieved (1987–2014). As expected, ITAC occurred predominantly in the nasal cavity in elderly patients (mean age 65 years) with a striking male predilection (15:2). Regardless of grade/subtype, all ITAC were invariably CK20 and CDX2 positive, and many (11/15) showed some CK7 positivity. Non-ITAC occurred in younger individuals (mean age 51 years) with a slight female predilection (male to female ratio: 10:13) and showed diverse morphologic patterns and grades, some with morphologic similarity to SSH. SSH occurred in younger individuals (mean age 33 years). Non-ITAC and SSH were invariably CK7 positive and CK20 negative, however, 4/22 non-ITAC and 2/5 SSH showed squamoid morular metaplasia that aberrantly expressed CDX2 and co-expressed nuclear β-catenin. Markers of seromucinous differentiation (S100, DOG1, and SOX10) were essentially absent in ITAC, but present to varying degrees in the majority of non-ITAC and all SSH. Thus, the term ‘seromucinous adenocarcinoma’ is the more appropriate designation for non-ITAC. Squamoid morules in non-ITAC and SSH may be an immunophenotypic pitfall given the aberrant CDX2 expression.
- Subjects :
- Nasal cavity
Adult
Male
Pathology
medicine.medical_specialty
endocrine system
Nose Neoplasms
Biology
Adenocarcinoma
Pathology and Forensic Medicine
Immunophenotyping
medicine
Biomarkers, Tumor
Humans
CDX2
Intestinal phenotype
Aged
Aged, 80 and over
Intestinal type
Original Paper
Morular Metaplasia
Mean age
Middle Aged
medicine.disease
Immunohistochemistry
medicine.anatomical_structure
Oncology
Otorhinolaryngology
Female
Male to female
Paranasal Sinus Neoplasms
Subjects
Details
- ISSN :
- 19360568
- Volume :
- 9
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Head and neck pathology
- Accession number :
- edsair.doi.dedup.....5fd1614a1c5ca1c91e2ecc7e8d9a6c5e