Human papillomavirus‐related carcinoma with adenoid cystic‐like features: a series of five cases expanding the pathological spectrum

Abstract

This study has further clarified the histological spectrum of this tumour type, and reports the first HPV type 16-related case. Diffuse p16 staining followed by HPV molecular testing is useful in distinguishing HPV-related carcinomas with adenoid cystic features from classic AdCCs.

Human Papillomavirus–Related Carcinoma With Adenoid Cystic–like Features of the Sinonasal Tract (Also Known as Human Papillomavirus–Related Multiphenotypic Sinonasal Carcinoma)

“…The scattered ductal cells are cuboidal, with pale or eosinophilic cytoplasm and vesicular nuclei arranged as focal ductal structures surrounded by basaloid cells. 6,8 Cell spindling, cytoplasmic clearing, and plasmacytoid morphology have also been reported. 7 Lymphovascular invasion, although rare, has been demonstrated in a case report published in 2018.…”

“…In addition, the typical hyalinized tumor stroma of AdCC and bone invasion are less frequently observed in HPV-related carcinoma with adenoid cystic-like features. 8 One large case series including 49 cases of HPV-related carcinoma with adenoid cystic-like features also reported the presence of slitlike (or hemangiopericytoma-like) vessels, epithelial-myoepithelial carcinoma-like components, sarcomatoid differentiation, and heterologous elements (chondroid and osseous) in these tumors.…”

“…HPV PHENOTYPING In contrast to sinonasal adenoid cystic carcinoma, which is rarely associated with HPV infection, [10][11][12] HPV-related carcinoma with adenoid cystic-like features is by definition associated with high-risk HPV infection, with a focus on HPV type 33 (most common) and type 35. 4,5 Andreasen et al 6 reported 1 case with HPV type 56 infection, and Hang et al 8 later presented the first case with HPV type 16. Unlike HPV-related carcinoma arising from uterine cervix, where latent HPV infection may be seen in more than 10% of healthy women, HPV is rarely present in normal sinonasal mucosa.…”

“…Besides the differences in morphologic features between HPV-related carcinoma with adenoid cystic-like features and AdCC mentioned above, p16 and MYB immunostaining followed by high-risk HPV testing and MYB/MYBL1 fluorescent in situ hybridization may be an appropriate strategy for further differential diagnosis in some equivocal cases. 6,8 The presence of a dual cell population comprising both ductal and myoepithelial cells in HPV-related carcinoma with adenoid cystic-like features can help to rule out nonkeratinizing squamous cell carcinoma, myoepithelial carcinoma, and polymorphous adenocarcinoma. Most basal cell adenocarcinomas have at least focal peripheral palisading, a low mitotic rate, and a low Ki-67 labeling index (mostly ,5%), and display diffuse nuclear staining of bcatenin 17 ; HPV-related carcinoma with adenoid cystic-like features generally shows the opposite results.…”

29. Angioleiomyoma with a plexiform pattern in the broad ligament – A case report

“…2 This distinction between HPV-related carcinoma with adenoid cystic-like features and classic AdCC has also been recently described in the sinonasal tract. 3…”