Department of Pathology, Royal Infirmary of Edinburgh, Edinburgh, UK.
Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK.
Head Neck Pathol. 2022 Dec;16(4):1227-1229. doi: 10.1007/s12105-022-01478-x. Epub 2022 Aug 3.
Combined neuroendocrine and squamous cell carcinoma (SCC) of the sinonasal tract is rare entity but is increasingly gaining recognition within the head and neck pathology community. In a recent series, a single case was reported to demonstrate diffuse p16 positivity despite lacking high-risk human papillomavirus (HPV) by RNA in-situ hybridisation (ISH). Here we describe a case of p16 positive combined neuroendocrine and SCC containing high-risk HPV. Retrospective case review of sinonasal carcinomas within the Head and Neck Pathology Department at Guy's and St Thomas' NHS Foundation Trust identified a single case of combined neuroendocrine and SCC. Clinico-demographic data was obtained through electronic hospital records. All immunohistochemistry and in-situ hybridisation were undertaken according to departmental standard operating procedures. Routine microscopy showed the tumour to comprise small and large cell neuroendocrine components as well as squamous and spindle cell elements. Small and large cells demonstrated CD56 and synaptophysin expression, whereas CK5/6 and p63 were confined to squamous components. There was diffuse p16 expression and punctate nuclear positivity for DNA ISH. We describe a case of HPV-associated combined neuroendocrine and SCC of the sinonasal tract. Recognition of HPV association with this entity avoids diagnostic pitfalls.
鼻腔鼻窦神经内分泌和鳞状细胞癌（SCC）的联合是一种罕见的实体，但在头颈部病理学领域中越来越受到重视。在最近的一系列研究中，尽管通过 RNA 原位杂交（ISH）缺乏高危型人乳头瘤病毒（HPV），但报道了一例弥漫性 p16 阳性的病例。在此，我们描述了一例含有高危型 HPV 的 p16 阳性的鼻腔鼻窦神经内分泌和 SCC 联合病例。通过电子医院记录，对盖伊和圣托马斯国民保健信托基金会头颈病理学系的鼻腔鼻窦癌进行回顾性病例回顾，发现了一例神经内分泌和 SCC 联合病例。通过电子医院记录，获得临床人口统计学数据。所有免疫组织化学和原位杂交均根据部门标准操作规程进行。常规显微镜检查显示肿瘤由小细胞和大细胞神经内分泌成分以及鳞状和梭形细胞成分组成。小细胞和大细胞表达 CD56 和突触素，而 CK5/6 和 p63 仅局限于鳞状成分。弥漫性 p16 表达和 DNA ISH 点状核阳性。我们描述了一例 HPV 相关的鼻腔鼻窦神经内分泌和 SCC 联合病例。认识到这种实体与 HPV 的相关性可以避免诊断陷阱。
