Résumé
Objective:To investigate the clinicopathological features,immunophenotype,and prognosis of head and neck spindle cell squamous cell carcinoma(SCSCC)to improve the understanding and diagnosis of this tumor.Methods:Clinicopathological data collected from January 2012 to December 2022 at the First Affiliated Hospital,Air Force Military Medical University from 20 patients with head and neck SCSCC were retrospectively reviewed for histological morphology and immunophenotype.In situ and fluorescence in situ hybridization were performed to detect EBV-encoded ribonucleic acid(EBER)status and MDM2 gene amplification,respectively.Results:The median age among the 20 SCSCC cases was 67 years with a male-to-female ratio of 4∶1.Tumor locations were laryngeal(35.0%)and sinonasal(30.0%).SCSCC presented as polypoid or exogenous growths(61.5%),often with surface ulceration(90.0%).Histologically,sarcomatoid growth pat-terns were exhibited in 75.0%of the patients(n=15),while the remainder showed granular tissue-like or angiosarcomatoid patterns.Most tumors(65.0%)displayed components of conventional squamous cell carcinomas,with a predominant occurrence of high to moderate dif-ferentiation(91.7%).In terms of immunohistochemistry,AE1/AE3 was expressed in 83.3%(15/18)of cases,while p63 and p40 expression rates were 62.5%and 66.7%,respectively.All cases were negative for EBER.The Ki-67 proliferation index ranged 10%-70%.Overall,33.3%(1/3)of the cases showed MDM2 gene amplification.Among these,the median follow-up time for 18 patients was 18.3 months(range:1-92 months),with 6 survivors and 12 deaths.Conclusions:Head and neck SCSCC is more prevalent among elderly male smokers,predominantly exhibits a polypoid growth pattern,and does not display human papillomavirus or Epstein-Barr virus infection.Diagnosis requires a compre-hensive evaluation of clinical and pathological features and immunophenotype.Surgical resection is the primary treatment method.
Résumé
Objective To investigate the distribution characteristics of the Epstein-Barr virus (EBV)in lymphomas.Methods 438 cases of lymphomas were reclassified according to the WHO classification of lymphoma (2008).ALK1,CD3,CD5,CD7,CD10,CD15,CD20,CD23,CD30,CD43,CD56,CD68,CD79,CD99,CyclinD1,EMA,IgD,TdT,Vs38C and LMP-1 were detected by in situ hybridization of EBER and immunohistochemistry.Results In B cell lymphoma,T and NK cell lymphoma and Hodgkin' s lymphoma (HL),the positive rates of EBER were 5.4 ％ (14/261),16.5 ％ (19/115) and 59.7 ％ (37/62),respectively,and the positive rates of LMP-1 were 5.4 ％ (14/261),5.2 ％ (6/115) and 59.7 ％ (37/62).In DLBCL patients,EBER expression in the older group was significantly higher than that in the younger one [13.2 ％ (7/53) vs 1.2 ％ (1/81),P ＜ 0.05].The expression of EBER and LMP-1 were inconsistent in T and NK cell lymphomas,and the positive rate of EBER was significantly higher than that of LMP-1 (P ＜ 0.05).EBER was all positive in 5 cases of NK/T cell lymphoma-nasal type.The expression of EBER and LMP-1 were consistent in HL.Conclusion The EBV infection was associated with the classification of the lymphoma.The EBV infection was the highest in NK/T cell lymphoma-nasal type,and the next was in HL.Due to the consistency of EBER and LMP-1 expression in the HL,economically,LMP-1 may replace EBER as the indicator of EBV.EBV might play an important role in the occurrence and development of NK/T cell lymphoma-nasal type,HL and so on.