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Consistent LEF-1 and MYB Immunohistochemical Expression in Human Papillomavirus-Related Multiphenotypic Sinonasal Carcinoma: A Potential Diagnostic Pitfall.

Abstract
Human papillomavirus (HPV)-related multiphenotypic sinonasal carcinoma (HMSC) is a distinct, newly-described sinonasal tract neoplasm characterized by a salivary gland tumor-like appearance with myoepithelial and ductal cells, frequent surface squamous dysplasia, and relatively indolent behavior. When considering a diagnosis of HMSC, aggressive high-grade salivary gland carcinomas, particularly those with a basaloid morphology such as basal cell adenocarcinoma and adenoid cystic carcinoma, enter the differential diagnosis. The full morphologic and immunophenotypic profile of HMSC continues to be unraveled. In this series of ten cases, we demonstrate that this tumor has consistent, strong immunohistochemical expression of LEF-1 yet lacks nuclear expression of β-catenin, and also has consistent yet variable expression of MYB protein. While LEF-1 expression may be a useful diagnostic adjunct, it can also be a pitfall, as other salivary tumors such as basal cell adenocarcinoma have been previously shown to express LEF-1. Additionally, MYB protein expression is not a discriminatory marker when trying to separate HMSC from adenoid cystic carcinoma.
AuthorsAkeesha A Shah, Bahram Robert Oliai, Justin A Bishop
JournalHead and neck pathology (Head Neck Pathol) Vol. 13 Issue 2 Pg. 220-224 (Jun 2019) ISSN: 1936-0568 [Electronic] United States
PMID30027386 (Publication Type: Journal Article)
Chemical References
  • Biomarkers, Tumor
  • LEF1 protein, human
  • Lymphoid Enhancer-Binding Factor 1
  • MYB protein, human
  • Proto-Oncogene Proteins c-myb
Topics
  • Adenocarcinoma (diagnosis)
  • Adult
  • Aged
  • Biomarkers, Tumor (analysis)
  • Carcinoma (diagnosis, virology)
  • Carcinoma, Adenoid Cystic (diagnosis)
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunohistochemistry
  • Lymphoid Enhancer-Binding Factor 1 (analysis, biosynthesis)
  • Male
  • Maxillary Sinus Neoplasms (diagnosis, virology)
  • Middle Aged
  • Papillomavirus Infections (complications, diagnosis)
  • Proto-Oncogene Proteins c-myb (analysis, biosynthesis)

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