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首页> 美国卫生研究院文献>Head and Neck Pathology >A Subset of Sinonasal Non-Intestinal Type Adenocarcinomas are Truly Seromucinous Adenocarcinomas: A Morphologic and Immunophenotypic Assessment and Description of a Novel Pitfall
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A Subset of Sinonasal Non-Intestinal Type Adenocarcinomas are Truly Seromucinous Adenocarcinomas: A Morphologic and Immunophenotypic Assessment and Description of a Novel Pitfall

机译：鼻腔非肠道型腺癌的一个子集是真正的浆液性腺癌：形态学和免疫表型评估和新型陷阱的描述。

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While sinonasal intestinal type adenocarcinoma (ITAC) is defined by an intestinal phenotype, non-intestinal type adenocarcinoma (non-ITAC) is traditionally viewed as a diagnosis of exclusion, despite previous implication of a seromucinous phenotype and similarity to sinonasal seromucinous hamartomas (SSH). We performed a comparison of clinicopathologic and immunophenotypic features of ITAC, non-ITAC and SSH using traditional discriminatory markers and new markers of seromucinous differentiation. Twenty-three non-ITAC, 17 ITAC, and 5 SSH were retrieved (1987–2014). As expected, ITAC occurred predominantly in the nasal cavity in elderly patients (mean age 65 years) with a striking male predilection (15:2). Regardless of grade/subtype, all ITAC were invariably CK20 and CDX2 positive, and many (11/15) showed some CK7 positivity. Non-ITAC occurred in younger individuals (mean age 51 years) with a slight female predilection (male to female ratio: 10:13) and showed diverse morphologic patterns and grades, some with morphologic similarity to SSH. SSH occurred in younger individuals (mean age 33 years). Non-ITAC and SSH were invariably CK7 positive and CK20 negative, however, 4/22 non-ITAC and 2/5 SSH showed squamoid morular metaplasia that aberrantly expressed CDX2 and co-expressed nuclear β-catenin. Markers of seromucinous differentiation (S100, DOG1, and SOX10) were essentially absent in ITAC, but present to varying degrees in the majority of non-ITAC and all SSH. Thus, the term ‘seromucinous adenocarcinoma’ is the more appropriate designation for non-ITAC. Squamoid morules in non-ITAC and SSH may be an immunophenotypic pitfall given the aberrant CDX2 expression.
机译：尽管鼻窦型腺癌（ITAC）是由肠表型定义的，但传统上将非肠型腺癌（non-ITAC）视为排除诊断，尽管先前暗示有血清粘蛋白表型和与鼻窦血清粘液性错构瘤（SSH）相似。我们使用传统的鉴别标记和血清黏蛋白分化的新标记对ITAC，非ITAC和SSH的临床病理和免疫表型特征进行了比较。检索了23个非ITAC，17个ITAC和5个SSH（1987-2014年）。不出所料，ITAC主要发生在老年患者（平均年龄65岁）的鼻腔中，男性偏向醒目（15：2）。无论等级/亚型如何，所有ITAC均恒定为CK20和CDX2阳性，并且许多（11/15）均显示出CK7阳性。非ITAC发生在较年轻的个体（平均年龄51岁）中，女性偏向轻度（男女比例：10：13），并且表现出不同的形态学模式和等级，有些形态与SSH相似。 SSH发生在较年轻的个体（平均年龄33岁）中。 Non-ITAC和SSH始终是CK7阳性和CK20阴性，但是，4/22 non-ITAC和2/5 SSH表现为鳞状小叶化生，异常表达CDX2和共表达核β-catenin。 ITAC中基本上不存在血清粘蛋白分化标记（S100，DOG1和SOX10），但在大多数非ITAC和所有SSH中都存在不同程度的标记。因此，“浆液性腺癌”一词对于非ITAC更合适。考虑到CDX2的异常表达，非ITAC和SSH中的鳞状桑ule可能是免疫表型陷阱。

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