Sinonasal Undifferentiated Carcinoma
- 1 February 2001
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in The American Journal of Surgical Pathology
- Vol. 25 (2), 156-163
- https://doi.org/10.1097/00000478-200102000-00003
Abstract
The role of Epstein-Barr virus (EBV) in the development of sinonasal undifferentiated carcinoma (SNUC) remains unresolved. Reports of EBV-positivity in SNUC may reflect inclusion of lymphoepithelioma-like carcinomas within this group. In addition, SNUC have been incompletely characterized immunohistochemically, and their undifferentiated appearance often requires such ancillary studies to aid in their distinction from other high-grade neoplasms. To address these two issues, 25 cases of SNUC diagnosed between the years 1983 and 1999 were selected from our files. EBER in situ hybridization (ISH) was performed on the paraffin-embedded tissue by using 3H-labeled EBER-1 RNA probes. Neoplasms with sufficient tissue (22 of 25) were evaluated immunohistochemically for Ki-67, p53, chromogranin, synaptophysin, placental alkaline phosphatase (PLAP), CD99, carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), neuron-specific enolase (NSE), and latent membrane protein-1 (LMP-1). The median patient age was 58 years (range, 20–81 years), with a male-to-female ratio of approximately 3:1. The most common tumor location was the nasal cavity (18 cases), followed by the ethmoid and maxillary sinuses. Median survival was 18 months. All 25 tumors were negative for EBER-1 by ISH. Ki-67 was negative in one case, 1+ in nine, 2+ in six, 3+ in five, and 4+ in one. P53 was negative in nine, 1+ in five, 2+ in two, 3+ in none, and 4+ in six. CD99 expression was strongly positive in 3 of 22 (14%) and completely negative in the remainder. Variably intense focal staining for EMA was present in 4 of 22 (18%). NSE faintly stained 4 of 22 (18%). Chromogranin, synaptophysin, PLAP, CEA, and LMP-1 were negative (0 of 22). Our results suggest that EBV does not play a role in the development of SNUC. Strict histologic criteria are necessary to avoid confusion with lymphoepithelioma-like carcinoma or other high-grade malignancies in this region. The finding of occasional CD99-positive cases adds SNUC to the growing list of CD99-positive neoplasms.This publication has 15 references indexed in Scilit:
- Sclerosing PerineuriomaThe American Journal of Surgical Pathology, 1997
- Concordance between p53 protein overexpression and gene mutation in a large series of common human carcinomasHuman Pathology, 1996
- Sinonasal undifferentiated carcinoma: A 10-year experienceAmerican Journal of Otolaryngology, 1996
- Epstein-Barr Virus Is Present in a Wide Histological Spectrum of Sinonasal CarcinomasThe American Journal of Surgical Pathology, 1995
- Detection of Epstein-Barr Viral RNA in Sinonasal Undifferentiated Carcinoma from Western and Asian PatientsThe American Journal of Surgical Pathology, 1994
- Sinonasal Undifferentiated Carcinoma: A Ray of HopeOtolaryngology -- Head and Neck Surgery, 1993
- Large Cell Carcinoma of the Lung with Neuroendocrine Differentiation: A Comparison with Large Cell “Undifferentiated” Pulmonary TumorsAmerican Journal of Clinical Pathology, 1992
- SynaptophysinThe American Journal of Surgical Pathology, 1987
- Sinonasal Undifferentiated CarcinomaThe American Journal of Surgical Pathology, 1986