University of Mississippi Medical Center, Jackson, MS 39216, USA.
Ann Diagn Pathol. 2011 Jun;15(3):181-4. doi: 10.1016/j.anndiagpath.2010.10.002. Epub 2011 Mar 10.
The World Health Organization classifies primary sinonasal adenocarcinomas (SNACs) into salivary and nonsalivary types. Salivary types are usually well-defined myoepithelial neoplasms, which closely resemble their salivary counterparts. Nonsalivary types are separated into intestinal-type SNAC (ITAC) and non-ITAC, and both have low- and high-grade categories. Intestinal-type SNACs are aggressive tumors that resemble intestinal epithelium and often arise in the ethmoid sinus. Non-ITACs are of presumed seromucous gland origin, have marked morphologic heterogeneity, and can arise anywhere in the sinonasal tract. Moreover, ITACs typically demonstrate an intestinal-type immunohistochemical profile (CK20+, CK7-, CDX2+, and villin+), whereas non-ITACs reveal a respiratory-type profile (CK20-, CK7+, CDX2-, and villin-). Here, we present a case of low-grade, nonintestinal SNAC in a 17-year-old African American man and a discussion of the classification and pathologic features of primary SNACs.
世界卫生组织将原发性鼻腔鼻窦腺癌 (SNAC) 分为唾液腺型和非唾液腺型。唾液腺型通常为界限清楚的肌上皮肿瘤，与相应的唾液腺肿瘤非常相似。非唾液腺型进一步分为肠型 SNAC (ITAC) 和非 ITAC，两者均有低级别和高级别两类。肠型 SNAC 是侵袭性肿瘤，类似于肠上皮，常发生在筛窦。非 ITAC 推测来源于浆液黏液腺，具有明显的形态异质性，可发生在鼻腔鼻窦的任何部位。此外，ITAC 通常表现出肠型免疫组化特征 (CK20 +, CK7 -, CDX2 +, 和 villin +)，而非 ITAC 则显示呼吸型特征 (CK20 -, CK7 +, CDX2 -, 和 villin -)。在此，我们报告了 1 例 17 岁非裔美国男性的低级别非肠型 SNAC，并讨论了原发性 SNAC 的分类和病理特征。
