Biphasic low-grade nasopharyngeal papillary adenocarcinoma: a case report and literature review

Yokoi, Hidenori; Terado, Yuichi; Fujiwara, Masachika; Matsumoto, Yuma; Ikeda, Tetsuya; Saito, Koichiro

doi:10.1186/s12907-018-0076-1

Cited by 12 publications

(9 citation statements)

References 20 publications

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“…Recently, Petersson et al [2] reported the presence of a spindle cell component in a patient with TLLG-NPPA. Only six cases of TLLG-NPPA exhibiting spindle cells have been reported to date [2,3,[8][9][10]. Here, we present another case of biphasic TLLG-NPPA that contained a prominent spindle cell component in a 50-year-old woman.…”

Section: Introductionmentioning

confidence: 81%

“…Only five case reports describing six patients with TLLG-NPPA exhibiting spindle cells have been published to date (Table 2) [2,3,5,[8][9][10]. The spindle cell component was prominent in only two of those cases [2,8]. Histologically, the spindle cell component did not exhibit severe nuclear pleomorphism or atypical mitoses.…”

Section: Discussionmentioning

confidence: 96%

“…The presence of spindle cells in TLLG-NPPA is an unusual phenomenon. Only five case reports describing six patients with TLLG-NPPA exhibiting spindle cells have been published to date (Table 2) [2,3,5,[8][9][10]. The spindle cell component was prominent in only two of those cases [2,8].…”

Section: Discussionmentioning

confidence: 99%

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Biphasic Thyroid-Like Low-Grade Nasopharyngeal Papillary Adenocarcinoma with a Prominent Spindle Cell Component: A Case Report

Lee¹,

Kim

et al. 2020

Diagnostics

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Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TLLG-NPPA) is a distinctly rare malignancy of the nasopharynx. Morphologically and immunophenotypically, TLLG-NPPA resembles papillary thyroid carcinoma (PTC) and is characterized by a papillary architecture with PTC-like nuclear features and thyroid transcription factor-1 expression. Recently, some cases of TLLG-NPPA with a spindle cell component have been reported. In this study, we report a very interesting case of biphasic TLLG-NPPA that was predominantly composed of spindle cells, with comprehensive analyses of its clinical, pathological, and immunophenotypical features. A 50-year-old woman presented with a sensation of a foreign body in the nasopharynx. Nasopharyngoscopy and computed tomography demonstrated a pedunculated mass arising from the nasopharyngeal roof. Based on the clinical impression of a nasopharyngeal tumor, an excisional biopsy was performed. At low-power magnification, the nasopharyngeal mass consisted of papillary tumor tissue, the growth pattern and architecture of which resembled those of PTC. The papillae were complex and packed tightly with fibrovascular cores. At high-power magnification, each papillary structure was lined with a pseudostratified cuboidal-to-columnar epithelium. The tumor cell nuclei frequently showed a ground-glass appearance, intranuclear grooves, pseudoinclusions, and membrane thickening and irregularity, resembling the characteristic nuclear morphology of PTC. These histological features were compatible with TLLG-NPPA. Intriguingly, in between the papillary components were spindle cells that appeared very similar to the glandular epithelial cells that imperceptibly merged with the papillary component. This spindle cell component comprised two-thirds of the entire tumor volume. The nuclear morphology of the spindle cell component was similar to that of the papillary component. On immunostaining, both the papillary and spindle cell components were diffusely and strongly positive for thyroid transcription factor-1, cytokeratin 7, cytokeratin 19, vimentin, and Hector Battifora mesothelial-1. In contrast, the tumor cells tested negative for p63, p40, smooth muscle actin, S-100, cytokeratin 5/6, thyroglobulin, BRAF V600E, and Epstein–Barr virus-encoded small RNAs. Only two cases of biphasic TLLG-NPPA exhibiting a prominent spindle cell component had been reported previously in the English literature. When the pathologist receives a primary nasopharyngeal mass with the aforementioned histological features, particularly biopsy specimens with predominant spindle cells, biphasic TLLG-NPPA should be considered in the differential diagnosis. By describing its detailed clinicopathological characteristics, we anticipate that this report will expand the existing knowledge on the spindle cell component associated with TLLG-NPPA.

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Section: Introductionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 96%

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Biphasic Thyroid-Like Low-Grade Nasopharyngeal Papillary Adenocarcinoma with a Prominent Spindle Cell Component: A Case Report

Lee¹,

Kim

et al. 2020

Diagnostics

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“…The spindle cell component was found in our case. In the previous literature up to 2019, only five cases of TL-LGNPPA with a prominent spindle cell component, named "biphasic low-grade nasopharyngeal papillary adenocarcinoma, " had been reported (7,10,12,26). Whether the etiology of biphasic LGNPPA differs from TL-LGNPPA without the spindle cell component and the reason why it develops in TL-LGNPPA remain unknown.…”

Section: Discussionmentioning

confidence: 99%

“…In their report, biphasic LGNPPA was differentiated from these tumors based on diffuse positivity of CK and no evidence of gene alternations such as SYT-SSX1/2 fusion transcripts t(X; 18) (p11.2; q11.2) against a biphasic synovial sarcoma, the absence of immunopositivity for CEA, calcitonin, and chromogranin A against medullary thyroid carcinoma, and the difference in originating regions or the expression of TTF-1 against a group of enigmatic neoplasms, respectively (12). Only one report mentioned TL-LGNPPA with squamous differentiation (22); however, Yokoi et al posited that the development of spindle cells occurred independently of squamous differentiation as the tumors were negative for CK5/6 and p40 (26). Further research and accumulation of cases are needed to elucidate the pathogenesis of TL-LGNPPA with the spindle cell component.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Features of Thyroid-Like Low-Grade Nasopharyngeal Papillary Adenocarcinoma: A Case Report and Review of the Literature

et al. 2020

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Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is an extremely rare neoplasm of the nasopharynx. Accordingly, its clinical and pathological characteristics are not well-known. We report a case of TL-LGNPPA and review the relevant literature on TL-LGNPPA. A 38-year-old Japanese woman presented with a history of nasal obstruction that had persisted for 1 month after symptoms of a common cold (e.g., low-grade fever, sore throat, and fatigue). A pedunculated tumor of ∼20 mm in diameter was found on the posterior edge of the nasal septum. The tumor was endoscopically resected. Based on careful histopathological and immunohistochemical examinations, it was diagnosed as TL-LGNPPA. At 5 years after surgery, the patient remained disease-free. TL-LGNPPA has a very good prognosis, and complete resection with a sufficient safety margin is recommended as the first-line treatment. The morphological characteristics and immunohistochemical findings, especially TTF-1 positivity and thyroglobulin negativity, are important for the diagnosis.

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Radiological features of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: case series and systematic review

Baba,

Matsushima,

Kessoku

et al. 2023

Neuroradiology

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Biphasic low-grade nasopharyngeal papillary adenocarcinoma: a case report and literature review

Cited by 12 publications

References 20 publications

Biphasic Thyroid-Like Low-Grade Nasopharyngeal Papillary Adenocarcinoma with a Prominent Spindle Cell Component: A Case Report

Biphasic Thyroid-Like Low-Grade Nasopharyngeal Papillary Adenocarcinoma with a Prominent Spindle Cell Component: A Case Report

Clinicopathological Features of Thyroid-Like Low-Grade Nasopharyngeal Papillary Adenocarcinoma: A Case Report and Review of the Literature

Radiological features of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: case series and systematic review

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