Nasopharyngeal Carcinoma

Epidemiology:

• distinctive geographical distribution
• Africa (parts) – most common childhood cancer
• Southern China – common in adults but rarely in children
• Rare in United States

Common sites:

• Nasopharynx (most)
• Tonsils
• Posterior tongue
• Upper airways

Gross features:

Histologic features:

• 3 patterns:
• keratinizing squamous cell carcinoma
• non-keratinizing squamous cell carcinoma
• undifferentiated carcinoma
• keratinizing squamous cell carcinoma:
• resembles well-differentiated SCC of other sites
• non-keratinizing squamous cell carcinoma (only a small proportion):
• resembles poorly-differentiated SCC of other sites
• must have distinct cell borders to call this rather than undifferentiated type
• undifferentiated carcinoma (“lymphoepithelioma”):
• abundant non-neoplastic lymphocytic infiltrate
• normal-appearing mature lymphocytes
• large epithelial cells
• oval to round, vesicular nuclei
• prominent nucleoli
• indistinct cell borders
• syncitium-like array
• may be spindled

Immunophenotype:

Marker:	Sensitivity:	Specificity:
EBV

Molecular features:

Other features:

• close anatomic relationship to lymphoid tissue
• association with EBV infection (most non-keratinizing and undifferentiated carcinomas)
• tend to be advanced on discovery, with spread to cervical nodes
• radiotherapy is standard treatment
• poor prognosis

References:

• Robbins 2005