Envisioning the Next WHO Head and Neck Classification

Brandwein-Gensler, Margaret; Wei, Shi

doi:10.1007/s12105-014-0529-5

Cited by 45 publications

(44 citation statements)

References 57 publications

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“…It is characterized by intraductal proliferation of low-grade ductal cells 9 No recurrences have been reported to date. 40 Metastatic disease has been reported in only one unusual lowgrade salivary duct carcinoma that demonstrated progression to high-grade intraductal and invasive salivary duct carcinoma, with multiple regional metastases of high-grade carcinoma. 41 As benign epithelial inclusions and epithelial displacements in lymph nodes from intraductal papillary or micropapillary lesions are known to occur, we conclude that our case of in situ low-grade salivary duct carcinoma with an associated epithelial island in a periparotid lymph node represents a benign epithelial lymph node inclusion or epithelium displacement rather than an occult metastasis.…”

Section: Discussionmentioning

confidence: 99%

Mammary analog secretory carcinoma, low-grade salivary duct carcinoma, and mimickers: a comparative study

et al. 2015

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Mammary analog secretory carcinoma (MASC) is a recently recognized low-grade salivary carcinoma characterized by a specific ETV6 rearrangement. We describe 14 new MASCs and examine their immunophenotypic and genetic profiles in the context of look-alikes, namely, low-and high-grade salivary duct carcinoma and acinic cell carcinoma. ETV6 rearrangement, and robust expression of mammaglobin and S100, were demonstrated in 11/11, 14/14, and 12/14 MASCs, respectively. All low-grade salivary duct carcinomas coexpressed S100/mammaglobin (6/6); none harbored ETV6 rearrangements (0/5). Given that S100/mammaglobin coexpression and absence of zymogen granules are features of both MASC and low-grade salivary duct carcinoma, these two are best distinguished histologically. The former is predominantly an extraductal neoplasm with bubbly pink cytoplasm, whereas the latter is a distinct intraductal micropapillary and cribriform process. Querying ETV6 gene status may be necessary for difficult cases. No acinic cell carcinoma expressed mammaglobin (0/13) or harbored an ETV6 rearrangement (0/7); only 1/13 acinic cell carcinomas weakly expressed S100. DOG1 expression was limited or absent among all tumor types, except acinic cell carcinoma which expressed DOG1 diffusely in a canalicular pattern. Therefore, histology and immunohistochemistry (mammaglobin, S100, DOG1) suffices in distinguishing acinic cell carcinoma from both MASC and low-grade salivary duct carcinoma. HER2 (ERBB2) amplification was detected in only 1/10 acinic cell carcinomas, but none of the MASCs or low-grade salivary duct carcinomas tested. High-grade salivary duct carcinomas frequently expressed mammaglobin (11/18) and harbored HER2 amplifications (13/15); none harbored ETV6 rearrangements (0/12). High-grade salivary duct carcinomas can easily be distinguished from these other entities by histology and HER2 amplification.

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Section: Discussionmentioning

confidence: 99%

Mammary analog secretory carcinoma, low-grade salivary duct carcinoma, and mimickers: a comparative study

et al. 2015

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“…In brief, sinonasal adenocarcinomas may be of salivary or non-salivary type, with the latter including intestinal type adenocarcinomas and non-intestinal adenocarcinomas, low-and high-grade [29]. Another rare low-grade entity, ''sinonasal renal celllike carcinoma'' has recently been described, which has some overlapping features with LGNIA [30].…”

Section: Differential Diagnosismentioning

confidence: 99%

Low-Grade Epithelial Proliferations of the Sinonasal Tract

Bullock

2016

Head and Neck Pathol

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Low-grade epithelial proliferations of the sinonasal tract include Schneiderian papillomas, respiratory epithelial adenomatoid hamartoma, seromucinous hamartoma and low-grade non-intestinal adenocarcinoma. There is considerable overlap in their clinical presentation, endoscopic appearance, and imaging features. Although well-described diagnostic criteria exist, a definitive diagnosis may be difficult to reach on a small biopsy. Schneiderian papillomas are divided into fungiform, inverted, and oncocytic types, each with characteristic clinical and morphological features. The latter two may progress to malignancy. The majority are still considered to be HPVrelated. Two lesions are designated as hamartomas, but their pathogenesis remains uncertain, with inflammatory and neoplastic origins proposed. Respiratory epithelial adenomatoid hamartoma is increasingly being recognized for its association with chronic rhinosinusitis and olfactory cleft site of origin. Seromucinous hamartoma has gained attention in recent years and overlaps with both respiratory epithelial adenomatoid hamartoma and low-grade non-intestinal adenocarcinoma. Controversy surrounds their distinction, particularly from low-grade adenocarcinoma. The latter generally is cured by complete excision, with a 26 % risk of recurrence but rare metastases and deaths from disease.

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“…The tumor can be organized in solid, nodular, or follicular forms with rare mitotic activity. Extension invasion and necrosis are not typically seen [7,8,11,12].…”

Section: Discussionmentioning

confidence: 99%

Sinonasal Renal Cell-Like Carcinoma: Case Report and Review of the Literature

Kubik

Barasch

Choby

et al. 2016

Head and Neck Pathol

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recent WHO classification of primary sinonasal malignancies contains 44 distinct histopathologic entities [3]. Understandably, these cancers present a formidable challenge for both the surgeon and pathologist.In this article we present an unusual case of clear cell neoplasia of the paranasal sinuses found to be consistent with sinonasal renal cell-like adenocarcinoma (SNRCLA). The finding of clear cell neoplasia in a sinonasal specimen is rare but associated with a surprisingly wide differential diagnosis. When evaluating the differential diagnosis for a clear cell neoplasm of the sinonasal tract, an underlying renal cell carcinoma (RCC) must first be ruled out. RCC is the most common metastatic lesion to the nasal cavity and paranasal sinuses [4] and approximately 6-15% of patients with RCC will have metastatic deposits in the head and neck [5,6]. In addition to metastatic RCC, other diagnostic considerations for clear cell neoplasia in the paranasal sinuses include a clear cell variant of squamous cell carcinoma, melanoma, primary salivary clear cell carcinoma, metastatic clear cell thyroid carcinoma, clear cell predominant mucoepidermoid carcinoma, and SNRCLA. Case ReportAn 80 year old female presented to our otolaryngology clinic with an asymptomatic right sinonasal mass. She reported a history of left sided acinic cell carcinoma treated at an outside institution with endonasal resection and adjuvant radiotherapy approximately eight years prior. Diagnostic nasal endoscopy revealed a large friable soft tissue mass arising from the lateral nasal wall near the axilla of the right middle turbinate. Imaging revealed a 3 cm tumor centered at the right nasolacrimal sac with extension superiorly to involve the nasal septum and dura of the anterior Abstract The differential diagnosis for clear cell neoplasms of the sinonasal tract is wide but critical to understand. In this paper, we describe a case of renal cell-like adenocarcinoma (SNRCLA) presenting as a paranasal sinus mass with clear cell morphology. The relevant literature is reviewed and the workup for clear cell neoplasms described. SNRCLA is a rarely encountered low grade glandular malignancy of the paranasal sinuses. Despite its morphologic mimicry of renal cell carcinoma, SNRCLA demonstrates a seromucinous phenotype and is associated with a favorable prognosis and low recurrence rates after surgical resection.

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Envisioning the Next WHO Head and Neck Classification

Abstract: The next WHO classification should abandon

Cited by 45 publications

References 57 publications

Mammary analog secretory carcinoma, low-grade salivary duct carcinoma, and mimickers: a comparative study

Mammary analog secretory carcinoma, low-grade salivary duct carcinoma, and mimickers: a comparative study

Low-Grade Epithelial Proliferations of the Sinonasal Tract

Sinonasal Renal Cell-Like Carcinoma: Case Report and Review of the Literature

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