Role of p40 and cytokeratin 5/6 in the differential diagnosis of sinonasal undifferentiated carcinoma

Singh, Lavleen; Ranjan, Richa; Arava, Sudheer; Singh, Manoj Kumar

doi:10.1016/j.anndiagpath.2014.01.003

Cited by 29 publications

(15 citation statements)

References 21 publications

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“…However, the actual specific extent of reactivity was not reported and further, they reported only one case of "pharynx SCC", and did not provide any HPV assessment, tumor grading, nor histologic typing. Singh et al [25] evaluated p40 and cytokeratin 5/6 in the differential diagnosis of sinonasal undifferentiated carcinoma, sinonasal "poorly differentiated" SCC, nasopharyngeal SCC, and olfactory neuroblastoma and reported that all ten sinonasal SCC were p40 and cytokeratin 5/6 positive. Bishop et al [26] evaluated p40 expression in head and neck spindle cell carcinomas and found that only 54% were positive.…”

Section: Discussionmentioning

confidence: 99%

Squamous and Neuroendocrine Specific Immunohistochemical Markers in Head and Neck Squamous Cell Carcinoma: A Tissue Microarray Study

Lewis

Chernock

Bishop

2017

Head and Neck Pathol

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The performance characteristics of neuroendocrine-specific and squamous-specific immunohistochemical markers in head and neck squamous cell carcinomas (SCC), in particular in oropharyngeal tumors in this era of human papillomavirus (HPV)-induced cases, are not well-established. The differential diagnosis for poorly differentiated SCCs, for nonkeratinizing oropharyngeal SCCs, and for other specific SCC variants such as basaloid SCC and undifferentiated (or lymphoepithelial-like) carcinomas includes neuroendocrine carcinomas. Given that neuroendocrine carcinomas of the head and neck are aggressive regardless of HPV status, separating them from SCC is critically important. In this study, we examined the neuroendocrine markers CD56, synaptophysin, and chromogranin-A along with the squamous markers p40 and cytokeratin 5/6 in a large tissue microarray cohort of oral, oropharyngeal, laryngeal, and hypopharyngeal SCCs with known HPV results by RNA in situ hybridization for the oropharyngeal tumors. Results were stratified by site and specific SCC variant. The neuroendocrine stains were rarely expressed in SCC (<1% overall) with CD56 the least, and chromogranin-A the most, specific markers. Further, p40 and cytokeratin 5/6 were very consistently expressed in all head and neck SCC (>98% overall), including very strong, consistent staining in oropharyngeal HPV-related nonkeratinizing SCC. Undifferentiated (or lymphoepithelial-like) carcinomas of the oropharynx are more frequently p40 or cytokeratin 5/6 negative or show only weak or focal expression. In summary, markers of neuroendocrine and squamous differentiation show very high specificity and sensitivity, respectively, across the different types of head and neck SCC.

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Section: Discussionmentioning

confidence: 99%

Squamous and Neuroendocrine Specific Immunohistochemical Markers in Head and Neck Squamous Cell Carcinoma: A Tissue Microarray Study

Lewis

Chernock

Bishop

2017

Head and Neck Pathol

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“…Since this classification, there has been ongoing debate about how to pathologically classify SNUC . More recently the cytokeratin (CK) pattern on immunohistochemistry has been employed to differentiate SNUC from other sinonasal tumors because they have been reported to express CK8, CK7, and CK19 while lacking CK5 and CK6 . SNUCs have also been investigated using a mass spectroscopy–based approach, but the authors were unable to identify any activating mutations in the 95 single‐nucleotide variations examined …”

Section: Sinonasal Malignanciesmentioning

confidence: 99%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

150

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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“…Variable reactivity can be seen with neuron specific enolase (NSE), chromogranin, and synaptophysin. SNUC usually shows only limited positivity for p63 and p40 [8][9][10][11], and this is a useful feature to separate it from poorly differentiated SCC and lymphoepithelioma. SNUC is typically negative for Epstein-Barr virus (EBV) [5,6], while association with HPV has been reported with variable, generally low, frequency [12,13].…”

Section: Epithelial Neoplasmsmentioning

confidence: 99%

An Update on Sinonasal Round Cell Undifferentiated Tumors

Franchi

2016

Head and Neck Pathol

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The sinonasal cavities host a wide variety of undifferentiated malignancies with round cell morphology, including neoplasms of epithelial, mesenchymal, neuroectodermal, and hematolymphoid lineage. The differential diagnosis may be difficult, especially in small biopsy material, due to overlapping morphology, but their correct classification is clinically relevant. The aim of this review is to provide practical guidelines for the differential diagnosis of these malignancies, with emphasis on recently described entities and special reference to the role of ancillary techniques.

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Role of p40 and cytokeratin 5/6 in the differential diagnosis of sinonasal undifferentiated carcinoma

Cited by 29 publications

References 21 publications

Squamous and Neuroendocrine Specific Immunohistochemical Markers in Head and Neck Squamous Cell Carcinoma: A Tissue Microarray Study

Squamous and Neuroendocrine Specific Immunohistochemical Markers in Head and Neck Squamous Cell Carcinoma: A Tissue Microarray Study

ICAR: endoscopic skull‐base surgery

An Update on Sinonasal Round Cell Undifferentiated Tumors

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