PMID- 35836519
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2219-6803 (Electronic)
IS  - 2218-676X (Print)
IS  - 2218-676X (Linking)
VI  - 11
IP  - 6
DP  - 2022 Jun
TI  - Case report: NUT carcinoma in an elderly woman with unique morphology and 
      immunophenotype highlights a diagnostic pitfall.
PG  - 1850-1860
LID - 10.21037/tcr-22-364 [doi]
AB  - BACKGROUND: NUT carcinoma (NC) is a rapidly progressing and rare neoplasm that 
      primarily affects younger patients and has a survival time of about 1 year. Most 
      of these neoplasms express epithelial markers with no neuroendocrine markers 
      observed. Retrospective studies have shown that pathologists and clinicians do 
      not have a sufficient understanding of the disease due to the lack of common 
      clinical manifestations, imaging, and morphological features. CASE DESCRIPTION: A 
      60-year-old female presented at Beijing Friendship Hospital, showing repetitive 
      epistaxis, nasal pain, and nasal congestion with obvious masses in the right 
      nasal sinus and frontal sinus. Microscope analysis revealed two unique 
      morphological changes which have not been previously reported in the existing 
      literature: (I) small spindle cells with sparse cytoplasm and densely stained 
      nuclei and (II) large tumor cells with abundant cytoplasm, some cells resembling 
      plasma cells. The sudden appearance of keratinization was also a prominent 
      feature. Immunohistochemical staining showed differences between the two cell 
      morphologies. Small spindle cells simultaneously expressed CK5/6 and P40, and the 
      Ki67 proliferation index was 40%. The large round cells did not express CK5/6 and 
      P40 but were focal positive for synaptophysin and the Ki67 index was 10%. NUT and 
      P63 were strongly expressed in both cell types and fluorescence in situ 
      hybridization (FISH) revealed BRD4-NUTM1 translocation. Following 20 rounds of 
      postoperative radiation treatment, the patient was alive and no recurrence or 
      metastasis was observed during a 5-month follow-up. CONCLUSIONS: We present novel 
      information from the oldest known and surviving patient of NC originating in the 
      nasal cavity with unique morphological features and different immunohistochemical 
      results. NUT antibody testing should be performed in undifferentiated or poorly 
      differentiated malignancies, particularly those with either or both cytoplasmic 
      vacuolation of medium-sized cells and abrupt keratinization, irrespective of 
      patient age.
CI  - 2022 Translational Cancer Research. All rights reserved.
FAU - Wei, Xuejing
AU  - Wei X
AD  - Department of Pathology, Beijing Friendship Hospital, Capital Medical University, 
      Beijing, China.
FAU - Teng, Xiaojing
AU  - Teng X
AD  - Department of Pathology, Beijing Friendship Hospital, Capital Medical University, 
      Beijing, China.
FAU - Zhang, Yanning
AU  - Zhang Y
AD  - Department of Pathology, Beijing Friendship Hospital, Capital Medical University, 
      Beijing, China.
FAU - Cheng, Ming
AU  - Cheng M
AD  - Department of Pathology, Beijing Friendship Hospital, Capital Medical University, 
      Beijing, China.
FAU - Chen, Guangyong
AU  - Chen G
AD  - Department of Pathology, Beijing Friendship Hospital, Capital Medical University, 
      Beijing, China.
LA  - eng
PT  - Case Reports
PL  - China
TA  - Transl Cancer Res
JT  - Translational cancer research
JID - 101585958
PMC - PMC9273665
OTO - NOTNLM
OT  - BRD4-NUTM1
OT  - NUT
OT  - NUT carcinoma (NC)
OT  - case report
OT  - sinonasal tract
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://tcr.amegroups.com/article/view/10.21037/tcr-22-364/coif). The authors 
      have no conflicts of interest to declare.
EDAT- 2022/07/16 06:00
MHDA- 2022/07/16 06:01
PMCR- 2022/06/01
CRDT- 2022/07/15 02:25
PHST- 2022/02/20 00:00 [received]
PHST- 2022/05/17 00:00 [accepted]
PHST- 2022/07/15 02:25 [entrez]
PHST- 2022/07/16 06:00 [pubmed]
PHST- 2022/07/16 06:01 [medline]
PHST- 2022/06/01 00:00 [pmc-release]
AID - tcr-11-06-1850 [pii]
AID - 10.21037/tcr-22-364 [doi]
PST - ppublish
SO  - Transl Cancer Res. 2022 Jun;11(6):1850-1860. doi: 10.21037/tcr-22-364.