Cancer Res Treat.  2017 Jan;49(1):213-218. 10.4143/crt.2016.195.

Clinicopathological Features of Low-Grade Thyroid-like Nasopharyngeal Papillary Adenocarcinoma

• Li M
• Wei J
• Yao X
• Wang C

• KMID: 2367519
• DOI: http://doi.org/10.4143/crt.2016.195

Abstract

PURPOSE
Primary low-grade thyroid-like papillary adenocarcinomas are extremely rare neoplasms that generally originate in the nasopharynx. Here, we describe a novel case of a 15-year-old Chinese girl who was diagnosed with low-grade thyroid-like papillary adenocarcinoma, including a brief review of the literature to reveal the clinicopathological features of low-grade thyroid-like nasopharyngeal papillary adenocarcinoma.
MATERIALS AND METHODS
Immunohistochemistry was used to evaluate the expression of pan-cytokeratin (CKpan), cytokeratin (CK) 7, thyroid transcription factor 1 (TTF-1), vimentin, epithelial membrane antigen (EMA), thyroglobulin, CD15, S100, P40, CK20, CDX-2, glial fibrillary acidic protein (GFAP), and Ki-67. Additionally, in situ hybridization investigation was utilized to identify the presence of small Epstein-Barr virus (EBV)-encoded RNA.
RESULTS
Histopathological analysis revealed florid proliferation of papillary structures lined by columnar epithelial cells with fibrovascular cores. Immunohistochemically, the neoplastic cells were positive for CKpan, CK7, TTF-1, vimentin, and EMA, but negative for thyroglobulin, CD15, S100, P40, CK20, CDX-2, and GFAP. The Ki-67-labeling index reached 5% in the most concentrated spot. In situ hybridization for EBV was negative.
CONCLUSION
Due to the distinct rarity of low-grade thyroid-like papillary adenocarcinomaswith a favorable clinical outcome, a nationwide effort to raise public awareness of this neoplasm is required.

Keyword

Papillary adenocarcinoma; Thyroid gland; Nasopharynx; Thyroid nuclear factor 1; Human herpesvirus 4

MeSH Terms

Adenocarcinoma, Papillary*
Adolescent
Asian Continental Ancestry Group
Epithelial Cells
Female
Glial Fibrillary Acidic Protein
Herpesvirus 4, Human
Humans
Immunohistochemistry
In Situ Hybridization
Keratins
Mucin-1
Nasopharynx
RNA
Thyroglobulin
Thyroid Gland
Transcription Factors
Vimentin
Glial Fibrillary Acidic Protein
Keratins
Mucin-1
RNA
Thyroglobulin
Transcription Factors
Vimentin

Figure

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  Fig. 1. Nasal endoscopy shows a pedunculated polypoid mass originating in the posterior nasal septum.

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  Fig. 2. (A) The tumor displayed papillary structures with hyalinized fibrovascular cores (H&E staining, ×100). (B) Most papillae were lined with cuboidal or columnar epithelia (H&E staining, ×200). (C) Overlapping round to ovoid nuclei that displayed fine chromatin and psammoma bodies were exhibited (H&E staining, ×400). (D) Strong positive staining of cytokeratin 7 was displayed (immunohistochemical [IHC] staining, ×200). (E) Nuclear staining for thyroid transcription factor 1 was shown (IHC staining, ×200). (F) Positivity of vimentin was evident (IHC staining, ×200).

Reference

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