[Low grade sinonasal adenocarcinoma].
Sinonasal adenocarcinoma is a rare neoplasm which is classified as     'intestinal' or 'nonintestinal' type, depending on its resemblance     to gastrointestinal mucosa. These tumors are associated with occupational and     environmental carcinogens. In this study, a fifty-year-old oil-painter male     patient with a low-grade nonintestinal type sinonasal adenocarcinoma originating     from the left middle concha and ethmoid sinus is presented. Microscopical     examination revealed many infiltrative glandular structures, most of which were     cystically dilated and some of which were smaller in diameter, arranged back to     back in loose fibrous stroma as well as intraglandular papillary and     micropapillary structures forming complex branches or a cribriform pattern. The     glands were lined by epithelial cells that were faintly eosinophilic and     relatively abundant cubical/ cylinderical cytoplasms and mildly pleomorphic     round/oval nuclei, with rare mitotic figures. Intraluminal and focally     intracytoplasmic mucin was demonstrated with Alcian Blue, mucicarmin and PAS     stains. Immunohistochemically, tumor cells were strongly and diffusely positive     with CK7; focally and weakly positive with CK20 and negative with CDX2 in     accordance with the nonintestinal type. S-100, Actin and p63, applied for     investigating the myoepithelial and salivary glandular origins, were all     negative. Prognostic markers, TTF-1 and p53 were negative; while the Ki-67 index     was 2%. The fact that intestinal type sinonasal adenocarcinomas are generally     high grade, while nonintestinal tumors are histologically low grade makes this     morphological and immunohistochemical-based classification valuable in     predicting the prognosis of the disease. In addition to the morphological and     immunohistochemical findings, clinical information stands out in the     differentiation of the tumor from benign or malignant primary lesions or     metastatic adenocarcinoma.
S. B. Okmeydanı Eğitim ve Araştırma Hastanesi, Patoloji Bölümü, İstanbul, Türkiye. tulaysay@gmail.com
Ayşe Tülay
AT
Sayilgan
Gülçin
G
Kamali
Deniz
D
Ozcan
Funda
F
Emre
Ayşe
A
Hatıpoğlu
D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D010255:Paranasal Sinus Neoplasms / Q000378:metabolism / Q000473:pathology*