Fine‐needle aspiration cytology of metastatic nasopharyngeal carcinoma

• Published in: Diagnostic cytopathology 2005-04, Vol.32 (4), p.233-237
• Main Authors: Viguer, José M., Jiménez‐Heffernan, José A., López‐Ferrer, Pilar, Banaclocha, Marcos, Vicandi, Blanca
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; aspiration biopsy; Biopsy, Fine-Needle; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - pathology; Child; cytology; Female; fine‐needle aspiration; Granuloma - pathology; Humans; Lymphoid Tissue - pathology; Male; Middle Aged; nasopharyngeal carcinoma; Nasopharyngeal Neoplasms - diagnosis; Nasopharyngeal Neoplasms - pathology
• ISSN: 8755-1039; 1097-0339
• DOI: 10.1002/dc.20216

Cytological features of nasopharyngeal carcinoma (NPC) were reviewed in an attempt to select cytological criteria that permit a specific recognition of metastases. For this purpose, 54 fine‐needle aspiration (FNA) procedures from 43 patients with NPC were analyzed. Thirty‐two (59.3%) procedures were performed before the histological diagnosis. In 25 (46.3%) procedures, smears showed many neoplastic single cells, clusters, and abundant lymphoid cells (mixed pattern). A dissociated (single cell) pattern consisting of individual neoplastic and lymphoid cells was seen in 18 (33.3%) cases. Finally, 11 (20.4%) cases showed cohesive epithelial clusters (cohesive pattern) without relevant cellular dissociation or lymphoid cells. Squamous‐cell differentiation was seen in three of these cases. Most single neoplastic cells presented as large, pleomorphic naked nuclei. Other interesting findings were granulomas (n = 3), prominent eosinophilic infiltrates (n = 4), and suppurative changes (n = 5). In most smears with mixed and dissociated patterns, a nasopharyngeal origin could be suggested. On the contrary, those smears with a cohesive pattern were indistinguishable from other head and neck carcinomas. The presence (on cervical lymph nodes) of a dissociated or mixed (single cells and groups) architectural pattern of large, anaplastic cells and naked nuclei accompanied by an abundant lymphoid component is highly suggestive of undifferentiated NPC. Cytology offers a rapid diagnosis, establishes the necessity of a complete cavum examination, and helps in avoiding unnecessary and harmful biopsies. Diagn. Cytopathol. 2005;32:233–237. © 2005 Wiley‐Liss, Inc.