Mills Stacey E
Robert E. Fechner Laboratory of Surgical Pathology, University of Virginia Health Sciences Center, Charlottesville, Virginia 22908, USA.
Mod Pathol. 2002 Mar;15(3):264-78. doi: 10.1038/modpathol.3880522.
Tumors exhibiting neuroectodermal differentiation occur throughout the body, and the diverse tissues of the head and neck give rise to a wide assortment of these neoplasms. Neuroectodermal neoplasms may be divided into lesions showing primarily epithelial differentiation (Group I, neuroendocrine carcinomas) and a more diverse group (Group II) of nonepithelial neoplasms. This article reviews these neuroectodermal tumors of the head and neck with emphasis on the neuroendocrine carcinomas and their nomenclature. The author believes that with regard to Group I tumors, the older terminology of carcinoid, atypical carcinoid, and small cell carcinoma should be replaced by subclassifications of well-differentiated, moderately differentiated, and poorly differentiated neuroendocrine carcinoma. The latter category should be further subdivided into small cell and large cell variants. Neuroendocrine carcinomas, particularly the moderately differentiated subtype, are often underdiagnosed in the head and neck region. In the larynx, these tumors are the most common form of nonsquamous carcinoma. Poorly differentiated neuroendocrine carcinoma of small cell type is most common in the salivary glands but can occur elsewhere in the region. The large cell subtype of poorly differentiated neuroendocrine carcinoma has not been well documented in this region. However, the most likely candidate for this tumor category is the so-called sinonasal undifferentiated carcinoma. Group II tumors discussed include olfactory neuroblastoma, malignant melanoma, and Ewing's sarcoma. In addition, differential diagnostic problems related to Group I and II tumors are reviewed in detail. This article reviews and updates our understanding of neuroectodermal neoplasms arising in the head and neck. The focus is on tumors that exclusively involve this region or show a strong predilection to occur here.
表现出神经外胚层分化的肿瘤遍布全身，头颈部的多种组织可产生各种各样的这类肿瘤。神经外胚层肿瘤可分为主要表现上皮分化的病变（第I组，神经内分泌癌）和更多样化的非上皮性肿瘤组（第II组）。本文回顾了头颈部的这些神经外胚层肿瘤，重点是神经内分泌癌及其命名。作者认为，对于第I组肿瘤，类癌、非典型类癌和小细胞癌等旧术语应被高分化、中分化和低分化神经内分泌癌的亚分类所取代。后一类应进一步细分为小细胞和大细胞变体。神经内分泌癌，尤其是中分化亚型，在头颈部区域常常诊断不足。在喉部，这些肿瘤是非鳞状癌最常见的形式。小细胞型低分化神经内分泌癌在涎腺中最常见，但也可发生在该区域的其他部位。低分化神经内分泌癌的大细胞亚型在该区域尚未得到充分记录。然而，这类肿瘤最可能的候选者是所谓的鼻窦未分化癌。讨论的第II组肿瘤包括嗅神经母细胞瘤、恶性黑色素瘤和尤因肉瘤。此外，还详细回顾了与第I组和第II组肿瘤相关的鉴别诊断问题。本文回顾并更新了我们对头颈部发生的神经外胚层肿瘤的认识。重点是专门累及该区域或在此处有强烈发生倾向的肿瘤。
