Immunohistochemical distinction of intestinal-type sinonasal adenocarcinoma from metastatic adenocarcinoma of intestinal origin

Vicente Resto, Jeffrey F. Krane, William C. Faquin, Derrick T. Lin

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objectives: Distinction of intestinal-type sinonasal adenocarcinoma (ITAC) from adenocarcinoma of intestinal origin metastatic to the sinonasal cavity may be extremely difficult on histologic grounds alone. We studied the role of cytokeratin (CK) and mucin (MUC) expression in differentiating ITAC, metastatic adenocarcinoma of intestinal origin, and non-intestinal-type sinonasal adenocarcinoma (non-ITAC). Methods: We stained specimens from 5 cases of ITAC and 4 cases of non-ITAC, along with 4 colonic and 3 duodenal adenocarcinoma controls, with CK7 and CK20, MUC2 and MUC5, neuron-specific enolase (NSE), chromogranin (CHR), and carcinoembryonic antigen (CEA) in order to examine the possible combinations of markers that best aid in the diagnosis of these lesions. We also performed a retrospective review of our clinical experience with these rare lesions. Results: CK7 staining was positive in all ITAC and non-ITAC cases, whereas all cases displaying gastrointestinal-type differentiation (ITAC and metastatic intestinal cases) stained positive for both CK20 and MUC2. Staining for MUC5, NSE, CHR, and CEA was variable. Conclusions: Tumors with the CK7+, CK20+, MUC2+ immunophenotype are likely primary sinonasal lesions, whereas tumors with the CK7-, CK20+, MUC2+ profile warrant further clinical evaluation to exclude metastatic disease from the gastrointestinal tract. Complete surgical resection of ITAC remains the mainstay of therapy.

Original languageEnglish (US)
Pages (from-to)59-64
Number of pages6
JournalAnnals of Otology, Rhinology and Laryngology
Volume115
Issue number1
StatePublished - Jan 2006
Externally publishedYes

Fingerprint

Adenocarcinoma
Chromogranins
Phosphopyruvate Hydratase
Carcinoembryonic Antigen
Staining and Labeling
Mucins
Keratins
Gastrointestinal Tract
Neoplasms

Keywords

  • Cytokeratin 20
  • Cytokeratin 7
  • Intestinal-type sinonasal adenocarcinoma
  • Mucin 2
  • Sinonasal metastatic adenocarcinoma

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Immunohistochemical distinction of intestinal-type sinonasal adenocarcinoma from metastatic adenocarcinoma of intestinal origin. / Resto, Vicente; Krane, Jeffrey F.; Faquin, William C.; Lin, Derrick T.

In: Annals of Otology, Rhinology and Laryngology, Vol. 115, No. 1, 01.2006, p. 59-64.

Research output: Contribution to journalArticle

@article{3a1b7f2cb33e406580bcf1927dbc02b6,
title = "Immunohistochemical distinction of intestinal-type sinonasal adenocarcinoma from metastatic adenocarcinoma of intestinal origin",
abstract = "Objectives: Distinction of intestinal-type sinonasal adenocarcinoma (ITAC) from adenocarcinoma of intestinal origin metastatic to the sinonasal cavity may be extremely difficult on histologic grounds alone. We studied the role of cytokeratin (CK) and mucin (MUC) expression in differentiating ITAC, metastatic adenocarcinoma of intestinal origin, and non-intestinal-type sinonasal adenocarcinoma (non-ITAC). Methods: We stained specimens from 5 cases of ITAC and 4 cases of non-ITAC, along with 4 colonic and 3 duodenal adenocarcinoma controls, with CK7 and CK20, MUC2 and MUC5, neuron-specific enolase (NSE), chromogranin (CHR), and carcinoembryonic antigen (CEA) in order to examine the possible combinations of markers that best aid in the diagnosis of these lesions. We also performed a retrospective review of our clinical experience with these rare lesions. Results: CK7 staining was positive in all ITAC and non-ITAC cases, whereas all cases displaying gastrointestinal-type differentiation (ITAC and metastatic intestinal cases) stained positive for both CK20 and MUC2. Staining for MUC5, NSE, CHR, and CEA was variable. Conclusions: Tumors with the CK7+, CK20+, MUC2+ immunophenotype are likely primary sinonasal lesions, whereas tumors with the CK7-, CK20+, MUC2+ profile warrant further clinical evaluation to exclude metastatic disease from the gastrointestinal tract. Complete surgical resection of ITAC remains the mainstay of therapy.",
keywords = "Cytokeratin 20, Cytokeratin 7, Intestinal-type sinonasal adenocarcinoma, Mucin 2, Sinonasal metastatic adenocarcinoma",
author = "Vicente Resto and Krane, {Jeffrey F.} and Faquin, {William C.} and Lin, {Derrick T.}",
year = "2006",
month = "1",
language = "English (US)",
volume = "115",
pages = "59--64",
journal = "Annals of Otology, Rhinology and Laryngology",
issn = "0003-4894",
publisher = "Annals Publishing Company",
number = "1",

}

TY - JOUR

T1 - Immunohistochemical distinction of intestinal-type sinonasal adenocarcinoma from metastatic adenocarcinoma of intestinal origin

AU - Resto, Vicente

AU - Krane, Jeffrey F.

AU - Faquin, William C.

AU - Lin, Derrick T.

PY - 2006/1

Y1 - 2006/1

N2 - Objectives: Distinction of intestinal-type sinonasal adenocarcinoma (ITAC) from adenocarcinoma of intestinal origin metastatic to the sinonasal cavity may be extremely difficult on histologic grounds alone. We studied the role of cytokeratin (CK) and mucin (MUC) expression in differentiating ITAC, metastatic adenocarcinoma of intestinal origin, and non-intestinal-type sinonasal adenocarcinoma (non-ITAC). Methods: We stained specimens from 5 cases of ITAC and 4 cases of non-ITAC, along with 4 colonic and 3 duodenal adenocarcinoma controls, with CK7 and CK20, MUC2 and MUC5, neuron-specific enolase (NSE), chromogranin (CHR), and carcinoembryonic antigen (CEA) in order to examine the possible combinations of markers that best aid in the diagnosis of these lesions. We also performed a retrospective review of our clinical experience with these rare lesions. Results: CK7 staining was positive in all ITAC and non-ITAC cases, whereas all cases displaying gastrointestinal-type differentiation (ITAC and metastatic intestinal cases) stained positive for both CK20 and MUC2. Staining for MUC5, NSE, CHR, and CEA was variable. Conclusions: Tumors with the CK7+, CK20+, MUC2+ immunophenotype are likely primary sinonasal lesions, whereas tumors with the CK7-, CK20+, MUC2+ profile warrant further clinical evaluation to exclude metastatic disease from the gastrointestinal tract. Complete surgical resection of ITAC remains the mainstay of therapy.

AB - Objectives: Distinction of intestinal-type sinonasal adenocarcinoma (ITAC) from adenocarcinoma of intestinal origin metastatic to the sinonasal cavity may be extremely difficult on histologic grounds alone. We studied the role of cytokeratin (CK) and mucin (MUC) expression in differentiating ITAC, metastatic adenocarcinoma of intestinal origin, and non-intestinal-type sinonasal adenocarcinoma (non-ITAC). Methods: We stained specimens from 5 cases of ITAC and 4 cases of non-ITAC, along with 4 colonic and 3 duodenal adenocarcinoma controls, with CK7 and CK20, MUC2 and MUC5, neuron-specific enolase (NSE), chromogranin (CHR), and carcinoembryonic antigen (CEA) in order to examine the possible combinations of markers that best aid in the diagnosis of these lesions. We also performed a retrospective review of our clinical experience with these rare lesions. Results: CK7 staining was positive in all ITAC and non-ITAC cases, whereas all cases displaying gastrointestinal-type differentiation (ITAC and metastatic intestinal cases) stained positive for both CK20 and MUC2. Staining for MUC5, NSE, CHR, and CEA was variable. Conclusions: Tumors with the CK7+, CK20+, MUC2+ immunophenotype are likely primary sinonasal lesions, whereas tumors with the CK7-, CK20+, MUC2+ profile warrant further clinical evaluation to exclude metastatic disease from the gastrointestinal tract. Complete surgical resection of ITAC remains the mainstay of therapy.

KW - Cytokeratin 20

KW - Cytokeratin 7

KW - Intestinal-type sinonasal adenocarcinoma

KW - Mucin 2

KW - Sinonasal metastatic adenocarcinoma

UR - http://www.scopus.com/inward/record.url?scp=31144442176&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=31144442176&partnerID=8YFLogxK

M3 - Article

C2 - 16466101

AN - SCOPUS:31144442176

VL - 115

SP - 59

EP - 64

JO - Annals of Otology, Rhinology and Laryngology

JF - Annals of Otology, Rhinology and Laryngology

SN - 0003-4894

IS - 1

ER -