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Presented by William Westra, M.D. and prepared by Doreen Nguyen, M.D.
Case 1: A 50 year-old woman presented with nasal obstruction and nasal bleeding.
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Question 1 of 1
1. Question
Week 559: Case 1
Clinical History: A 50 year-old woman presented with nasal obstruction and nasal bleeding (imaging study provided).
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images/d nguyen/7-15-13/case 1/Picture5_450 pixels.jpgCorrect
Answer: HPV-related sinonasal carcinoma with adenoid cystic-like features
Histology: Microscopically, the carcinoma is seen as highly cellular proliferations of basaloid cells compacted into expanding lobules. Rounded nests of varying sizes and shapes are separated by thin fibrous bands of collagenized stroma. The pattern of growth is predominantly solid, but cribriforming growth is also present. In these cribriform areas, basaloid cells align around cylindromatous microcystic spaces filled with a basophilic material.
The predominant cell type is the basaloid cell. These basaloid cells are characterized by hyperchromatic and slightly angulated nuclei, scant cytoplasm, and a high nuclear to cytoplasmic ratio. Although the invasive component of the tumor does not exhibit overt keratinization, the overlying surface epithelium demonstrates dysplastic changes characterized by full thickness dyspolarity and cellular atypia.
A second cell type, the true ductal cell, is highlighted by cKIT immunohistochemical staining.
The ductal cell is surrounded by a layer of p63 positive basaloid cells.
p16
High Risk HPV ISH
Discussion:
Reference(s):
Incorrect
Answer: HPV-related sinonasal carcinoma with adenoid cystic-like features
Histology: Microscopically, the carcinoma is seen as highly cellular proliferations of basaloid cells compacted into expanding lobules. Rounded nests of varying sizes and shapes are separated by thin fibrous bands of collagenized stroma. The pattern of growth is predominantly solid, but cribriforming growth is also present. In these cribriform areas, basaloid cells align around cylindromatous microcystic spaces filled with a basophilic material.
The predominant cell type is the basaloid cell. These basaloid cells are characterized by hyperchromatic and slightly angulated nuclei, scant cytoplasm, and a high nuclear to cytoplasmic ratio. Although the invasive component of the tumor does not exhibit overt keratinization, the overlying surface epithelium demonstrates dysplastic changes characterized by full thickness dyspolarity and cellular atypia.
A second cell type, the true ductal cell, is highlighted by cKIT immunohistochemical staining.
The ductal cell is surrounded by a layer of p63 positive basaloid cells.
p16
High Risk HPV ISH
Discussion:
Reference(s):
