Skip to main content
Top
Published in: Head and Neck Pathology 4/2011

01-12-2011 | Original Paper

Expression of p16 in Sinonasal Undifferentiated Carcinoma (SNUC) Without Associated Human Papillomavirus (HPV)

Authors: Beth Wadsworth, Jeffery M. Bumpous, Alvin W. Martin, Michael R. Nowacki, Alfred B. Jenson, Hanan Farghaly

Published in: Head and Neck Pathology | Issue 4/2011

Login to get access

Abstract

Sinonasal undifferentiated carcinoma (SNUC) is an uncommon and highly aggressive neoplasm of the paranasal sinuses and nasal cavity. Its undifferentiated histologic appearance often requires immunohistochemical studies to distinguish it from other high-grade neoplasms. Due to the rarity of SNUC, its immunohistochemical staining profile has been incompletely characterized, and little work has been done on its expression of the markers for human papillomavirus (HPV). Our objective is to expand our knowledge of its immunophenotype and its association with HPV in order to define markers with mechanistic potential in the disease process, or of possible therapeutic importance. A total of five patients (one woman and four men) with SNUC, ranging in age from 26 to 75 years (mean 56.8 years) were compared to five patients (five men) with poorly differentiated squamous cell carcinoma (PDSCC), ranging in age from 53 to 75 years (mean 62.2 years). PDSCC was chosen as a control, given its well-reported immunohistochemical profile and negativity for HPV markers. The immunohistochemical panel included: CK7, CK19, EMA, NSE, chromogranin, p53, CK5/6, p63, CK14, S100, HMB-45, desmin, muscle specific actin, and CD45. Additionally, tests for p16, EBV, and HPV (subtypes 6, 11 16, 18) were performed. The diagnosis of SNUC was confirmed in all cases by histology and immunohistochemical stains. An interesting finding of strong diffuse positivity for p16 was noted in all SNUC cases, compared to only two of five PDSCC that were positive for p16. HPV DNA was not detected in any SNUC cases or any cases of PDSCC. All SNUC cases demonstrated over expression of p16 in the absence of HPV DNA expression. This may represent residual epithelial p16 staining, which is normally present in the sinonasal tract. Due to the rarity of SNUC, more cases will need to be evaluated to confirm the absence of HPV DNA.
Literature
1.
go back to reference Frierson HF Jr. Sinonasal undifferentiated carcinoma. In: Barnes L, Eveson JW, Reichart P, Sidransky D, editors. World Health Organization classification of tumors. Lyon: IARC Press; 2005. p. 19. Frierson HF Jr. Sinonasal undifferentiated carcinoma. In: Barnes L, Eveson JW, Reichart P, Sidransky D, editors. World Health Organization classification of tumors. Lyon: IARC Press; 2005. p. 19.
2.
go back to reference Pilch BZ. Tumors of the upper respiratory tract, part B: larynx and trachea. In: Fletcher CD, editor. Diagnostic histopathology of tumors. 3rd ed. Philadelphia, PA: Churchill Livingstone; 2007. p. 112–5. Pilch BZ. Tumors of the upper respiratory tract, part B: larynx and trachea. In: Fletcher CD, editor. Diagnostic histopathology of tumors. 3rd ed. Philadelphia, PA: Churchill Livingstone; 2007. p. 112–5.
3.
go back to reference Hunt JL, Barnes L. Immunohistology of head and neck neoplasms. In: Dabbs D, editor. Diagnostic immunohistochemistry. 2nd ed. Philadelphila, PA: Churchill Livingstone; 2006. p. 232–5. Hunt JL, Barnes L. Immunohistology of head and neck neoplasms. In: Dabbs D, editor. Diagnostic immunohistochemistry. 2nd ed. Philadelphila, PA: Churchill Livingstone; 2006. p. 232–5.
4.
go back to reference Stelow EB, Bellizzi AM, Taneja K, et al. NUT rearrangement in undifferentiated carcinomas of the upper aerodigestive tract. Am J Surg Pathol. 2008;32(6):828–34.PubMedCrossRef Stelow EB, Bellizzi AM, Taneja K, et al. NUT rearrangement in undifferentiated carcinomas of the upper aerodigestive tract. Am J Surg Pathol. 2008;32(6):828–34.PubMedCrossRef
5.
go back to reference Desai PC, Jaglal MV, Gopal P, et al. Human papillomavirus in metastatic squamous carcinoma from unknown primaries in the head and neck: a retrospective 7 year study. Exp Mol Pathol. 2009;87(2):94–8.PubMedCrossRef Desai PC, Jaglal MV, Gopal P, et al. Human papillomavirus in metastatic squamous carcinoma from unknown primaries in the head and neck: a retrospective 7 year study. Exp Mol Pathol. 2009;87(2):94–8.PubMedCrossRef
6.
go back to reference Frierson HF Jr, Mills SE, Fechner RE, et al. Sinonasal undifferentiated carcinoma: an aggressive neoplasm derived from Schneiderian epithelium and distinct from olfactory neuroblastoma. Am J Surg Pathol. 1986;10(11):771–9.PubMedCrossRef Frierson HF Jr, Mills SE, Fechner RE, et al. Sinonasal undifferentiated carcinoma: an aggressive neoplasm derived from Schneiderian epithelium and distinct from olfactory neuroblastoma. Am J Surg Pathol. 1986;10(11):771–9.PubMedCrossRef
7.
go back to reference Smith SR, Som P, Fahmy A, et al. A clinicopathological study of sinonasal neuroendocrine carcinoma and sinonasal undifferentiated carcinoma. Laryngoscope. 2000;110(10 Pt 1):1617–22.PubMedCrossRef Smith SR, Som P, Fahmy A, et al. A clinicopathological study of sinonasal neuroendocrine carcinoma and sinonasal undifferentiated carcinoma. Laryngoscope. 2000;110(10 Pt 1):1617–22.PubMedCrossRef
8.
go back to reference Franchi A, Moroni M, Massi D, et al. Sinonasal undifferentiated carcinoma, nasopharyngeal-type undifferentiated carcinoma, and keratinizing and nonkeratinizing squamous cell carcinoma express different cytokeratin patterns. Am J Surg Pathol. 2002;26(12):1597–604.PubMedCrossRef Franchi A, Moroni M, Massi D, et al. Sinonasal undifferentiated carcinoma, nasopharyngeal-type undifferentiated carcinoma, and keratinizing and nonkeratinizing squamous cell carcinoma express different cytokeratin patterns. Am J Surg Pathol. 2002;26(12):1597–604.PubMedCrossRef
9.
go back to reference Cerilli LA, Holst VA, Brandwein MS, et al. Sinonasal undifferentiated carcinoma: immunohistochemical profile and lack of EBV association. Am J Surg Pathol. 2001;25(2):156–63.PubMedCrossRef Cerilli LA, Holst VA, Brandwein MS, et al. Sinonasal undifferentiated carcinoma: immunohistochemical profile and lack of EBV association. Am J Surg Pathol. 2001;25(2):156–63.PubMedCrossRef
10.
go back to reference Dunn ST, Clark GD, Cannon TC, et al. Survey of sinonasal inverted papillomata for Epstein-Barr virus. Head Neck. 1997;19(2):98–106.PubMedCrossRef Dunn ST, Clark GD, Cannon TC, et al. Survey of sinonasal inverted papillomata for Epstein-Barr virus. Head Neck. 1997;19(2):98–106.PubMedCrossRef
11.
go back to reference Jeng YM, Sung MT, Fang CL, et al. Sinonasal undifferentiated carcinoma and nasopharyngeal-type carcinoma: two clinically, biologically, and histopathologically distinct entities. Am J Surg Pathol. 2002;26(3):371–6.PubMedCrossRef Jeng YM, Sung MT, Fang CL, et al. Sinonasal undifferentiated carcinoma and nasopharyngeal-type carcinoma: two clinically, biologically, and histopathologically distinct entities. Am J Surg Pathol. 2002;26(3):371–6.PubMedCrossRef
12.
go back to reference Gallo O, Di Lollo S, Graziani P, et al. Detection of Epstein-Barr virus genome in sinonasal undifferentiated carcinoma by use of in situ hybridization. Otolaryngol Head Neck Surg. 1995;112:659–64.PubMedCrossRef Gallo O, Di Lollo S, Graziani P, et al. Detection of Epstein-Barr virus genome in sinonasal undifferentiated carcinoma by use of in situ hybridization. Otolaryngol Head Neck Surg. 1995;112:659–64.PubMedCrossRef
13.
go back to reference Major T, Szarka K, Sziklai I, et al. The characteristics of human papillomavirus DNA in head and neck cancers and papillomas. J Clin Pathol. 2005;58(1):51–5.PubMedCrossRef Major T, Szarka K, Sziklai I, et al. The characteristics of human papillomavirus DNA in head and neck cancers and papillomas. J Clin Pathol. 2005;58(1):51–5.PubMedCrossRef
14.
go back to reference Reidy PM, Dedo HH, Rabah R, et al. Integration of human papillomavirus type 11 in recurrent respiratory papilloma-associated cancer. Laryngoscope. 2004;114(11):1906–9.PubMedCrossRef Reidy PM, Dedo HH, Rabah R, et al. Integration of human papillomavirus type 11 in recurrent respiratory papilloma-associated cancer. Laryngoscope. 2004;114(11):1906–9.PubMedCrossRef
15.
go back to reference Syrjänen KJ. HPV infections in benign and malignant sinonasal lesions. J Clin Pathol. 2003;56(3):174–81.PubMedCrossRef Syrjänen KJ. HPV infections in benign and malignant sinonasal lesions. J Clin Pathol. 2003;56(3):174–81.PubMedCrossRef
16.
go back to reference Syrjänen S. Human papillomaviruses in head and neck carcinomas. N Engl J Med. 2007;356(19):1993–5.PubMedCrossRef Syrjänen S. Human papillomaviruses in head and neck carcinomas. N Engl J Med. 2007;356(19):1993–5.PubMedCrossRef
17.
go back to reference El-Mofty SK, Lu DW. Prevalence of high-risk human papillomavirus DNA in nonkeratinizing (cylindrical cell) carcinoma of the sinonasal tract: a distinct clinicopathologic and molecular disease entity. Am J Surg Pathol. 2005;29(10):1367–72.PubMedCrossRef El-Mofty SK, Lu DW. Prevalence of high-risk human papillomavirus DNA in nonkeratinizing (cylindrical cell) carcinoma of the sinonasal tract: a distinct clinicopathologic and molecular disease entity. Am J Surg Pathol. 2005;29(10):1367–72.PubMedCrossRef
18.
go back to reference Rassekh CH, Rady PL, Arany I, et al. Combined Epstein-Barr virus and human papillomavirus infection in nasopharyngeal carcinoma. Laryngoscope. 1998;108(3):362–7.PubMedCrossRef Rassekh CH, Rady PL, Arany I, et al. Combined Epstein-Barr virus and human papillomavirus infection in nasopharyngeal carcinoma. Laryngoscope. 1998;108(3):362–7.PubMedCrossRef
19.
go back to reference Ritchie JM, Smith EM, Summersgill KF, et al. Human papillomavirus infection as a prognostic factor in carcinomas of the oral cavity and oropharynx. Int J Cancer. 2003;104(3):336–44.PubMedCrossRef Ritchie JM, Smith EM, Summersgill KF, et al. Human papillomavirus infection as a prognostic factor in carcinomas of the oral cavity and oropharynx. Int J Cancer. 2003;104(3):336–44.PubMedCrossRef
20.
go back to reference Badaracco G, Rizzo C, Mafera B, et al. Molecular analyses and prognostic relevance of HPV in head and neck tumours. Oncol Rep. 2007;17(4):931–9.PubMed Badaracco G, Rizzo C, Mafera B, et al. Molecular analyses and prognostic relevance of HPV in head and neck tumours. Oncol Rep. 2007;17(4):931–9.PubMed
21.
go back to reference Fakhry C, Westra WH, Li S, et al. Improved survival of patients with human papillomavirus—positive head and neck squamous cell carcinoma in a prospective clinical trial. J Natl Cancer Inst. 2008;100:261–9.PubMedCrossRef Fakhry C, Westra WH, Li S, et al. Improved survival of patients with human papillomavirus—positive head and neck squamous cell carcinoma in a prospective clinical trial. J Natl Cancer Inst. 2008;100:261–9.PubMedCrossRef
22.
go back to reference Klussmann JP, Mooren JJ, Lehnen M, et al. Genetic signatures of HPV-related and unrelated oropharyngeal carcinoma and their prognostic implications. Clin Cancer Res. 2009;15(5):1779–86.PubMedCrossRef Klussmann JP, Mooren JJ, Lehnen M, et al. Genetic signatures of HPV-related and unrelated oropharyngeal carcinoma and their prognostic implications. Clin Cancer Res. 2009;15(5):1779–86.PubMedCrossRef
23.
go back to reference D’Souza G, Kreimer AR, Viscidi R, et al. Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med. 2007;356(19):1944–56.PubMedCrossRef D’Souza G, Kreimer AR, Viscidi R, et al. Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med. 2007;356(19):1944–56.PubMedCrossRef
24.
go back to reference Reimers N, Kasper HU, Weissenborn SJ, et al. Combined analysis of HPV-DNA, p16 and EGFR expression to predict prognosis in oropharyngeal cancer. Int J Cancer. 2007;120(8):1731–8.PubMedCrossRef Reimers N, Kasper HU, Weissenborn SJ, et al. Combined analysis of HPV-DNA, p16 and EGFR expression to predict prognosis in oropharyngeal cancer. Int J Cancer. 2007;120(8):1731–8.PubMedCrossRef
25.
go back to reference McKaig RG, Baric RS, Olshan AF. Human papillomavirus and head and neck cancer: epidemiology and molecular biology. Head Neck. 1998;20(3):250–65.PubMedCrossRef McKaig RG, Baric RS, Olshan AF. Human papillomavirus and head and neck cancer: epidemiology and molecular biology. Head Neck. 1998;20(3):250–65.PubMedCrossRef
26.
go back to reference Ragin CC, Modugno F, Gollin SM. The epidemiology and risk factors of head and neck cancer: a focus on human papillomavirus. J Dent Res. 2007;86(2):104–14. Review.PubMedCrossRef Ragin CC, Modugno F, Gollin SM. The epidemiology and risk factors of head and neck cancer: a focus on human papillomavirus. J Dent Res. 2007;86(2):104–14. Review.PubMedCrossRef
27.
go back to reference Pietruszewska W, Rieske P, Murlewska A, et al. Expression of p16 and protein in the evaluation of dynamics of laryngeal cancer growth. Otolaryngol Pol. 2004;58(1):173–80.PubMed Pietruszewska W, Rieske P, Murlewska A, et al. Expression of p16 and protein in the evaluation of dynamics of laryngeal cancer growth. Otolaryngol Pol. 2004;58(1):173–80.PubMed
28.
go back to reference Holladay EB, Logan S, Arnold J, et al. A comparison of the clinical utility of p16(INK4a) immunolocalization with the presence of human papillomavirus by hybrid capture 2 for the detection of cervical dysplasia/neoplasia. Cancer. 2006;108(6):451–61.PubMedCrossRef Holladay EB, Logan S, Arnold J, et al. A comparison of the clinical utility of p16(INK4a) immunolocalization with the presence of human papillomavirus by hybrid capture 2 for the detection of cervical dysplasia/neoplasia. Cancer. 2006;108(6):451–61.PubMedCrossRef
30.
go back to reference Schwerer MJ, Sailer A, Kraft K, et al. Expression of retinoblastoma gene product in respiratory epithelium and sinonasal neoplasms: relationship with p16 and cyclin D1 expression. Histol Histopathol. 2003;18(1):143–51.PubMed Schwerer MJ, Sailer A, Kraft K, et al. Expression of retinoblastoma gene product in respiratory epithelium and sinonasal neoplasms: relationship with p16 and cyclin D1 expression. Histol Histopathol. 2003;18(1):143–51.PubMed
31.
go back to reference Klussmann JP, Gultekin E, Weissenborn SJ, et al. Expression of p16 protein identifies a distinct entity of tonsillar carcinomas associated with human papillomavirus. Am J Pathol. 2003;162:747–53.PubMedCrossRef Klussmann JP, Gultekin E, Weissenborn SJ, et al. Expression of p16 protein identifies a distinct entity of tonsillar carcinomas associated with human papillomavirus. Am J Pathol. 2003;162:747–53.PubMedCrossRef
32.
go back to reference Smeets SJ, Hesselink AT, Speel EJ, et al. A novel algorithm for reliable detection of human papillomavirus in paraffin embedded head and neck cancer specimen. Int J Cancer. 2007;121(11):2465–72.PubMedCrossRef Smeets SJ, Hesselink AT, Speel EJ, et al. A novel algorithm for reliable detection of human papillomavirus in paraffin embedded head and neck cancer specimen. Int J Cancer. 2007;121(11):2465–72.PubMedCrossRef
33.
go back to reference Gorelick J, Ross D, Marentette L, et al. Sinonasal undifferentiated carcinoma: a case series and review of the literature. Neurosurgery. 2000;47(3):750–5.PubMed Gorelick J, Ross D, Marentette L, et al. Sinonasal undifferentiated carcinoma: a case series and review of the literature. Neurosurgery. 2000;47(3):750–5.PubMed
34.
go back to reference Thompson L. Malignant neoplasms of the nasal cavity, paranasal sinuses, and nasopharynx. In: Thompson L, editor. Head and neck pathology. Philadelphia: Churchill Livingstone; 2006. p. 168–71. Thompson L. Malignant neoplasms of the nasal cavity, paranasal sinuses, and nasopharynx. In: Thompson L, editor. Head and neck pathology. Philadelphia: Churchill Livingstone; 2006. p. 168–71.
Metadata
Title
Expression of p16 in Sinonasal Undifferentiated Carcinoma (SNUC) Without Associated Human Papillomavirus (HPV)
Authors
Beth Wadsworth
Jeffery M. Bumpous
Alvin W. Martin
Michael R. Nowacki
Alfred B. Jenson
Hanan Farghaly
Publication date
01-12-2011
Publisher
Springer US
Published in
Head and Neck Pathology / Issue 4/2011
Electronic ISSN: 1936-0568
DOI
https://doi.org/10.1007/s12105-011-0285-8

Other articles of this Issue 4/2011

Head and Neck Pathology 4/2011 Go to the issue

Sine qua none Radiology-Pathology

Central Giant Cell Lesion