Difference between revisions of "Sinonasal undifferentiated carcinoma"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Sinonasal_undifferentiated_carcinoma_-_high_mag.jpg
| Width      =
| Caption    = SNUC. [[H&E stain]].
| Synonyms  =
| Micro      = tumour with variable architecture (nested, trabecular or lobular), small-to-moderate cytoplasm, +/-distinct nucleoli, cell size variable (small to large); glandular and squamous differentiation are absent by definition
| Subtypes  =
| LMDDx      = poorly differentiated [[squamous cell carcinoma of the head and neck]], [[small cell carcinoma]], others
| Stains    =
| IHC        = pankeratin +ve, [[EMA]] +ve, CK7 +ve, CK5/6 -ve, NSE +ve/-ve, chromogranin A -ve, synaptophysin -ve, p63 +ve/-ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[head and neck pathology|head and neck]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = rare
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = poor
| Other      =
| ClinDDx    = other head and neck tumours
| Tx        =
}}
'''Sinonasal undifferentiated carcinoma''', abbreviated '''SNUC''', is a rare epithelial malignancy of the [[head and neck pathology|head and neck]].
'''Sinonasal undifferentiated carcinoma''', abbreviated '''SNUC''', is a rare epithelial malignancy of the [[head and neck pathology|head and neck]].


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*Glandular and squamous differentiation are absent by definition.<ref name=pmid11904342/>
*Glandular and squamous differentiation are absent by definition.<ref name=pmid11904342/>


Images:
DDx:
*www:
*Poorly differentiated [[squamous cell carcinoma of the head and neck]].
**[http://www.nature.com/modpathol/journal/v15/n3/fig_tab/3880522f7.html SNUC (nature.com)].<ref name=pmid11904342>{{Cite journal  | last1 = Mills | first1 = SE. | title = Neuroectodermal neoplasms of the head and neck with emphasis on neuroendocrine carcinomas. | journal = Mod Pathol | volume = 15 | issue = 3 | pages = 264-78 | month = Mar | year = 2002 | doi = 10.1038/modpathol.3880522 | PMID = 11904342 | URL = http://dx.doi.org/10.1038/modpathol.3880522 }}</ref>
*[[Small cell carcinoma]].
**[http://www.pathologypics.com/PictView.aspx?ID=244 SNUC (pathologypics.com)].
*Other tumours.
**[http://www.pathologypics.com/PictView.aspx?ID=249 SNUC (pathologypics.com)].
 
*[[WC]]:
===Images===
**[http://commons.wikimedia.org/wiki/File:Sinonasal_undifferentiated_carcinoma_-_low_mag.jpg SNUC - low mag. (WC)].
www:
**[http://commons.wikimedia.org/wiki/File:Sinonasal_undifferentiated_carcinoma_-_high_mag.jpg SNUC - high mag. (WC)].
*[http://www.nature.com/modpathol/journal/v15/n3/fig_tab/3880522f7.html SNUC (nature.com)].<ref name=pmid11904342>{{Cite journal  | last1 = Mills | first1 = SE. | title = Neuroectodermal neoplasms of the head and neck with emphasis on neuroendocrine carcinomas. | journal = Mod Pathol | volume = 15 | issue = 3 | pages = 264-78 | month = Mar | year = 2002 | doi = 10.1038/modpathol.3880522 | PMID = 11904342 | URL = http://dx.doi.org/10.1038/modpathol.3880522 }}</ref>
**[http://commons.wikimedia.org/wiki/File:Sinonasal_undifferentiated_carcinoma_-_very_high_mag.jpg SNUC - very high mag. (WC)].
*[http://www.pathologypics.com/PictView.aspx?ID=244 SNUC (pathologypics.com)].
*[http://www.pathologypics.com/PictView.aspx?ID=249 SNUC (pathologypics.com)].
<gallery>
Image:Sinonasal_undifferentiated_carcinoma_-_low_mag.jpg | SNUC - low mag. (WC)
Image:Sinonasal_undifferentiated_carcinoma_-_high_mag.jpg | SNUC - high mag. (WC)
Image:Sinonasal_undifferentiated_carcinoma_-_very_high_mag.jpg | SNUC - very high mag. (WC)
</gallery>


==IHC==
==IHC==

Revision as of 07:00, 27 July 2014

Sinonasal undifferentiated carcinoma
Diagnosis in short

SNUC. H&E stain.

LM tumour with variable architecture (nested, trabecular or lobular), small-to-moderate cytoplasm, +/-distinct nucleoli, cell size variable (small to large); glandular and squamous differentiation are absent by definition
LM DDx poorly differentiated squamous cell carcinoma of the head and neck, small cell carcinoma, others
IHC pankeratin +ve, EMA +ve, CK7 +ve, CK5/6 -ve, NSE +ve/-ve, chromogranin A -ve, synaptophysin -ve, p63 +ve/-ve
Site head and neck

Prevalence rare
Prognosis poor
Clin. DDx other head and neck tumours

Sinonasal undifferentiated carcinoma, abbreviated SNUC, is a rare epithelial malignancy of the head and neck.

General

  • Aggressive/poor prognosis.
    • In the past, survival was measured in months.[1]
    • With (aggressive) combined modality treatment, the overall five-year survival is approximately 75%.[2]

Microscopic

Features:[3]

  • Architecture: nested, trabecular or lobular.
  • Distinct cellular borders.
  • Small-to-moderate cytoplasm.
  • +/-Distinct nucleoli.
  • Tumour cell size variable (small to large).

Note:

  • Glandular and squamous differentiation are absent by definition.[4]

DDx:

Images

www:

IHC

Features:[3]

  • Pankeratin +ve.
  • EMA +ve.
  • CK7 +ve.
  • CK5/6 -ve.

Others:

  • NSE +ve/-ve.
  • Chromogranin A -ve.
  • Synaptophysin -ve.
  • p63 +ve/-ve.[5]

See also

References

  1. Pitman, KT.; Costantino, PD.; Lassen, LF. (1995). "Sinonasal undifferentiated carcinoma: current trends in treatment.". Skull Base Surg 5 (4): 269-72. PMC 1656535. PMID 17170968. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1656535/.
  2. Al-Mamgani, A.; van Rooij, P.; Mehilal, R.; Tans, L.; Levendag, PC. (Apr 2012). "Combined-modality treatment improved outcome in sinonasal undifferentiated carcinoma: single-institutional experience of 21 patients and review of the literature.". Eur Arch Otorhinolaryngol. doi:10.1007/s00405-012-2008-5. PMID 22476411.
  3. 3.0 3.1 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 38. ISBN 978-0781765275.
  4. 4.0 4.1 Mills, SE. (Mar 2002). "Neuroectodermal neoplasms of the head and neck with emphasis on neuroendocrine carcinomas.". Mod Pathol 15 (3): 264-78. doi:10.1038/modpathol.3880522. PMID 11904342.
  5. Wadsworth, B.; Bumpous, JM.; Martin, AW.; Nowacki, MR.; Jenson, AB.; Farghaly, H. (Dec 2011). "Expression of p16 in sinonasal undifferentiated carcinoma (SNUC) without associated human papillomavirus (HPV).". Head Neck Pathol 5 (4): 349-54. doi:10.1007/s12105-011-0285-8. PMC 3210220. PMID 21805120. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210220/.