Mucosal Large Cell Neuroendocrine Cancer of Head and Neck
Mucosal Large Cell Neuroendocrine Cancer of Head and Neck
Backgrounds Large cell neuroendocrine carcinoma (LCNEC) is well-known as a lung cancer subtype. This study assessed the prevalence of head and neck mucosal LCNEC (M-LCNEC).
Methods M-LCNEC was studied clinically, histologically and immunohistochemically.
Results Of 814 surgically resected cases of mucosal head and neck carcinoma, only eight cases (0.98%; all men, mean age 64.6 years) were rediagnosed as M-LCNEC. They occurred in the oropharynx (n=3), larynx (n=4) and hypopharynx (n=1). Seven of the cases had regional lymph node metastases and four resulted in death. Histologically, M-LCNEC had a sheet-like trabacular organoid growth pattern of relatively large basaloid cells in which central necrosis, rosette formation, peripheral palisading and high mitotic figures were evident. M-LCNEC was immunopositive for two or three neuroendocrine markers (CD56, chromogranin-A and synaptophysin). All cases showed high proliferative activity.
Conclusion M-LCNEC in the head and neck regions is a distinct histopathological entity whose positivity for neuroendocrine markers makes its diagnosis important. As about half of the patients died of the disease, M-LCNEC has a relatively poor prognosis.
Large cell carcinoma is a well-known lung cancer subtype. Large cell neuroendocrine carcinoma (LCNEC) is an organoid growth pattern of large atypical cells which are immunopositive for more than one kind of neuroendocrine (NE) marker including CD56, chromogranin-A (ChA) and synaptophysin (Syn). Clinically, LCNEC of the lungs usually preludes a poor prognosis. LCNEC has also been reported in other organs such as the ovary, stomach and urinary bladder, which similarly heralds a poor prognosis.
To the best of our knowledge, only five cases of LCNEC in the head and neck regions arising from the parotid gland have been reported in the English literature, as well as one case of LCNEC arising from the tongue base mucosa. A recent report described 10 cases (six new cases and four previously reported cases) of laryngeal LCNEC. The present study was undertaken to assess the lesion concept of LCNEC arising from the mucosa of the head and neck regions in Japanese patients and to describe the clinicopathological features of mucosal LCNEC (M-LCNEC).
Abstract and Introduction
Abstract
Backgrounds Large cell neuroendocrine carcinoma (LCNEC) is well-known as a lung cancer subtype. This study assessed the prevalence of head and neck mucosal LCNEC (M-LCNEC).
Methods M-LCNEC was studied clinically, histologically and immunohistochemically.
Results Of 814 surgically resected cases of mucosal head and neck carcinoma, only eight cases (0.98%; all men, mean age 64.6 years) were rediagnosed as M-LCNEC. They occurred in the oropharynx (n=3), larynx (n=4) and hypopharynx (n=1). Seven of the cases had regional lymph node metastases and four resulted in death. Histologically, M-LCNEC had a sheet-like trabacular organoid growth pattern of relatively large basaloid cells in which central necrosis, rosette formation, peripheral palisading and high mitotic figures were evident. M-LCNEC was immunopositive for two or three neuroendocrine markers (CD56, chromogranin-A and synaptophysin). All cases showed high proliferative activity.
Conclusion M-LCNEC in the head and neck regions is a distinct histopathological entity whose positivity for neuroendocrine markers makes its diagnosis important. As about half of the patients died of the disease, M-LCNEC has a relatively poor prognosis.
Introduction
Large cell carcinoma is a well-known lung cancer subtype. Large cell neuroendocrine carcinoma (LCNEC) is an organoid growth pattern of large atypical cells which are immunopositive for more than one kind of neuroendocrine (NE) marker including CD56, chromogranin-A (ChA) and synaptophysin (Syn). Clinically, LCNEC of the lungs usually preludes a poor prognosis. LCNEC has also been reported in other organs such as the ovary, stomach and urinary bladder, which similarly heralds a poor prognosis.
To the best of our knowledge, only five cases of LCNEC in the head and neck regions arising from the parotid gland have been reported in the English literature, as well as one case of LCNEC arising from the tongue base mucosa. A recent report described 10 cases (six new cases and four previously reported cases) of laryngeal LCNEC. The present study was undertaken to assess the lesion concept of LCNEC arising from the mucosa of the head and neck regions in Japanese patients and to describe the clinicopathological features of mucosal LCNEC (M-LCNEC).
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