Low-grade sinonasal adenocarcinomas: the association with and distinction from respiratory epithelial adenomatoid hamartomas and other glandular lesions

• Published in: The American journal of surgical pathology Vol. 33; no. 3; p. 401
• Main Authors: Jo, Vickie Y, Mills, Stacey E, Cathro, Helen P, Carlson, Diane L, Stelow, Edward B
• Format: Journal Article
• Language: English
• Published: United States 01.03.2009
• Subjects: Adenocarcinoma - complications; Adenocarcinoma - metabolism; Adenocarcinoma - pathology; Adolescent; Adult; Aged; Aged, 80 and over; Diagnosis, Differential; Female; Hamartoma - complications; Hamartoma - metabolism; Hamartoma - pathology; Humans; Immunohistochemistry; Male; Middle Aged; Nose Neoplasms - complications; Nose Neoplasms - metabolism; Nose Neoplasms - pathology; Paranasal Sinuses - metabolism; Paranasal Sinuses - pathology; Respiratory Mucosa - metabolism; Respiratory Mucosa - pathology
• ISSN: 1532-0979
• DOI: 10.1097/PAS.0b013e3181874ee8

Sinonasal adenocarcinomas (SNACs) are uncommon malignancies that show a variety of growth patterns. These lesions are classified as intestinal or nonintestinal, the latter subclassified as low grade or high grade. We have noted that some low-grade nonintestinal SNACs are associated with respiratory epithelial adenomatoid hamartomas (REAHs), also rare lesions that have recently been shown to be neoplastic. We reviewed 29 nonintestinal low-grade SNACs seen at our institution over a 20-year period, with particular attention to morphology and concomitant REAHs. Nine (31%) low-grade SNACs demonstrated a predominantly exophytic and papillary growth pattern, and 18 (72%) had a more tubular growth pattern. Two (7%) were categorized as "other." Six low-grade tubular SNACs were associated with REAHs. An immunohistochemical panel was performed on 2 of these cases; neoplastic cells were immunoreactive with antibodies to CK7 and S100 protein and nonreactive with antibodies to CK20, similar to other low-grade SNACs. No basal cells or myoepithelial differentiation was seen with immunohistochemical stains for p63 and 34betaE12. This association of low-grade tubular SNACs with REAHs suggests that REAHs may be related to some adenocarcinomas.