Adenocarcinomas of the inner nose after exposure to wood dust

Abstract

We present the results of light microscopic, available electron microscopic and immunohistochemical investigations of 79 adenocarcinomas occurring in the noses of wood workers following exposure to beechwood and oakwood dust. Three types of adenocarcinomas can be differentiated. The most frequently occurring form is the papillary tubular cylinder cell adenocarcinoma, while the mucus-producing alveolar goblet cell adenocarcinoma and signet ring cell adenocarcinoma are rarer types. Transitional stages suggest the common origin of these tumors from mucus-secreting cylinder cells of the respiratory epithelium. The grade of differentiation and the tumor type are definitely related to the prognosis of these tumors. Similar to the tumors of the gastrointestinal tract, electron microscopy and immunohistochemistry prove the existence of a number of various polypeptide hormones, the significance of which has not yet been clarified.

Gene expression profiling in sinonasal adenocarcinoma

“…Two main types of sinonasal adenocarcinoma are recognized in the ethmoid sinus based on the histological similarity to adenocarcinoma of the intestine: Intestinal Type Adenocarcinoma (ITAC) and non-Intestinal Type Adenocarcinoma (non-ITAC). ITAC can be further divided into five categories [15,25]: the "papillary-type" (well-differentiated adenocarcinoma), the "colonic-type" (moderately-differentiated adenocarcinoma), the "solid-type" (poorly-differentiated adenocarcinoma), the "mucinous--type" and the "mixed--type" composed of a mixture of the previously defined patterns. Non-ITAC are divided into low-grade and high-grade subtypes.…”

“…Although the etiology of sinonasal adenocarcinoma is well-defined, its wood-related pathogenesis is not clearly understood [13]. From a morphological and histopathological point of view, these tumors are mainly intestinal-type adenocarcinomas [14,15] and demonstrate characteristic changes, such as gland formation, seen in adenocarcinomas at other anatomic sites. The most common clinical symptoms (nosebleeding, rhinitis and nasal obstruction) are not specific and this explains the delay in the diagnosis and the frequency of advanced stages.…”

Benign Lesions in Mucosa Adjacent to Intestinal-Type Sinonasal Adenocarcinoma

“…The latter is not related to professional wood dust exposure and is not the subject of this paper. Based on classifications of Barnes and Kleinsasser [2, 4], five pathological types of sinonasal ITAC are distinguished: papillary or papillary tubular cylinder cell I (PTCC-I), colonic (PTCC-II), solid (PTCC-III), mucinous (alveolar goblet and signet ring), and mixed (transitional). The most frequent type is colonic (40%), followed by solid (20%), papillary (18%), and mucinous and mixed type (together 22%) [3].…”

“…Distant or lymph node metastases are exceptional, while local recurrences constitute the main cause of death among patients [8, 9]. The median age of onset lies between 50 and 60 years [4, 10] and in wood dust-related tumors even earlier [10]. Men develop ITAC four times more frequently than women, reflecting the occupational hazard implicated [4].…”

“…The median age of onset lies between 50 and 60 years [4, 10] and in wood dust-related tumors even earlier [10]. Men develop ITAC four times more frequently than women, reflecting the occupational hazard implicated [4]. …”