In vivo real-time diagnosis of nasopharyngeal carcinoma in situ by contact rhinoscopy.
BACKGROUND
Nasopharyngeal dysplasia or nasopharyngeal carcinoma in situ (NPCIS) lesions have rarely been reported. Timely diagnosis of the preinvasive lesion may improve prognosis. Contact endoscopy has been documented to accurately differentiate normal cells of the nasopharynx from malignant cells and allows a real-time diagnosis of primary and recurrent nasopharyngeal carcinoma (NPC) in a clinical setting. However, the role of contact endoscopy in the diagnosis of NPCIS is unknown.


METHODS
The superficial cells of the nasopharynx in a patient with NPCIS were examined in vivo under local anaesthesia by use of a contact rhinoscope. The contact endoscopic findings were correlated with the histologic findings of the biopsy.


RESULTS
The atypical cells of the lesion were magnified and visualized under contact endoscopy. Histopathologic analysis of the biopsied tissue confirmed the presence of NPCIS staining positively for Epstein-Barr virus (EBV)-encoded RNA (EBER). No cell-free EBV DNA was detected in the sera of the patient.


CONCLUSIONS
Contact endoscopy can accurately identify the atypical cells of a tiny preinvasive lesion in the nasopharynx in a clinical setting, which may not be evident in routine imaging examination.
Wai Pak
Martin
M
Division of Otorhinolaryngology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, SAR, China.
To
Ka Fai
KF
Lee
Joseph Chuen Kwun
JC
Liang
Eisen Yee
EY
van Hasselt
Charles Andrew
CA
D000328:Adult; D000956:Antigens, Viral / Q000235:genetics / Q000276:immunology; D001706:Biopsy; D036022:Capsid Proteins / Q000235:genetics / Q000276:immunology; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D004279:DNA, Viral / Q000097:blood; D004724:Endoscopy / Q000379:methods*; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D017403:In Situ Hybridization; D008279:Magnetic Resonance Imaging; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis
D000956:Antigens, Viral; D036022:Capsid Proteins; D004279:DNA, Viral; C041788:Epstein-Barr viral capsid antigen; D012367:RNA, Viral