Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Respiratory and Critical Care Division of Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea.
Thorac Cancer. 2020 Nov;11(11):3205-3212. doi: 10.1111/1759-7714.13648. Epub 2020 Oct 3.
Nuclear protein in testis (NUT) carcinoma is a rare tumor associated with NUT rearrangement that can present as poorly differentiated to undifferentiated carcinoma, with or without abrupt squamous differentiation. It is often misdiagnosed as poorly differentiated carcinoma or undifferentiated carcinoma if NUT is not suspected. In this study, we retrospectively analyzed pulmonary NUT carcinoma cases diagnosed with NUT immunohistochemical staining and discuss the differential diagnosis to provide information for this rare and aggressive entity.
Cases, diagnosed as "NUT carcinoma" in lung pleura and "metastatic NUT carcinoma from the lung" in lymph nodes were diagnosed between 2017 and 2019 at the Samsung Medical Center (SMC). Clinical features such as age, sex, treatment and follow-up period, and pathological reports were obtained by reviewing patients' electronic medical records.
A total of 10 NUT carcinoma cases were found in the SMC pathology database. Seven patients were men and six were non-smokers. Tumor cells showed various cellular features such as round, squamoid, and spindle. Some cases had initially been misdiagnosed as spindle cell neoplasm, round cell sarcoma, squamous cell carcinoma and small cell carcinoma. All cases showed diffuse strong nuclear expression of NUT immunohistochemical staining, and some were positive for p63 staining and negative for CD56 staining.
NUT carcinoma is often misdiagnosed because of its various morphologies. It is important to consider NUT as one of the differential diagnoses when encountering lung biopsy with undifferentiated morphology.
Due to various morphological features, NUT carcinoma can be misdiagnosed It is important to consider NUT carcinoma when diagnosing a poorly differentiated or undifferentiated tumor.
睾丸核蛋白（NUT）癌是一种罕见的与 NUT 重排相关的肿瘤，可表现为低分化或未分化癌，伴有或不伴有突然的鳞状分化。如果不怀疑 NUT，则常被误诊为低分化癌或未分化癌。本研究回顾性分析了经 NUT 免疫组织化学染色诊断为肺 NUT 癌的病例，并探讨了鉴别诊断，为这一罕见且侵袭性实体瘤提供信息。
在三星医疗中心（SMC），2017 年至 2019 年期间诊断为“肺胸膜 NUT 癌”和“肺转移性 NUT 癌”的病例被诊断为 NUT 癌。通过查阅患者的电子病历，获得了年龄、性别、治疗和随访时间以及病理报告等临床特征。
在 SMC 病理数据库中发现了 10 例 NUT 癌病例。7 例患者为男性，6 例为非吸烟者。肿瘤细胞具有圆形、鳞状和梭形等多种细胞特征。一些病例最初被误诊为梭形细胞肿瘤、圆形细胞肉瘤、鳞状细胞癌和小细胞癌。所有病例均表现为 NUT 免疫组织化学染色弥漫强核表达，部分病例 p63 染色阳性，CD56 染色阴性。
由于其多种形态学特征，NUT 癌常被误诊。在遇到形态学未分化的肺活检时，考虑 NUT 为鉴别诊断之一非常重要。
由于具有多种形态学特征，NUT 癌可能被误诊。在诊断低分化或未分化肿瘤时，应考虑 NUT 癌。
