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Case 245 - Discussion

Uploaded: 2011-12-12, Updated: 2011-12-12

 

The tumor cells are positive for cytokeratin and EBER.

 

 

Undifferentiated Nasopharyngeal Carcinoma

  • Also called lymphoepithelioma
  • Bimodal age distribution: in teens and patients >50 years of age
  • Commonly metastasize to cervical lymph nodes, often as initial presentation
  • Morphology
    • Syncytial growth pattern of relatively uniform tumor cells with indistinct cell margins
    • Tumor cells are large in size and  have vesicular nuclei and prominent nucleoli. Tumor may contain spindle cells and scattered effete (“worn out”) cells with shrunken, hyperchromatic nuclei
    • Usually contain abundant inflammatory cells, including lymphocytes, plasma cells, eosinophils and macrophages; patterns below may be mixed or with one cell type predominant (eosinophil predominant in this case)
  • EBER-ISH positive in almost all cases
  • Treatment:  radiotherapy and  chemotherapy, 70-90% 5-year overall survival