Diagnosis of nasopharyngeal carcinoma.

The diagnosis of nasopharyngeal carcinoma rests on perceptive symptom analysis, a careful clinical examination, and the selection of appropriate clinical investigations. A high index of suspicion is required. When mirror examination fails to provide a satisfactory view of the nasopharynx, flexible or rigid nasopharyngeal endoscopy is mandatory. Serologic examination of IgA antibodies to Epstein-Barr virus early antigen and viral capsid antigen is helpful in identifying high-risk patients. Biopsy material should be sent fresh to the laboratory for analysis so that special staining can be carried out in cases of doubtful diagnosis.