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Is neuroendocrine differentiation useful to discriminate primary sinonasal intestinal-type adenocarcinomas from metastatic colorectal adenocarcinomas?
  1. Fabrice Projetti1,2,
  2. Elie Serrano2,3,
  3. Sebastien Vergez2,4,
  4. Anne-Charlotte Bissainthe1,2,
  5. Marie-Bernadette Delisle1,5,
  6. Emmanuelle Uro-Coste1,2
  1. 1Department of Pathology, Universitary Institute of Cancer, Toulouse, France
  2. 2Rangueil medical university, Toulouse, France
  3. 3Department of Otorhinolaryngology—Head and Neck Surgery, Rangueil-Larrey University Hospital, Toulouse, France
  4. 4Department of Otorhinolaryngology—Head and Neck Surgery, Universitary Institute of Cancer, Toulouse, France
  5. 5Department of Pathology, Rangueil University Hospital, Toulouse, France
  1. Correspondence to Fabrice Projetti, Department of Pathology, Universitary Institute of Cancer, 1 Avenue Irène Joliot-Curie, Toulouse 31059, cedex 9, France; projetti.fabrice{at}gmail.com

Abstract

Primary sinonasal intestinal-type adenocarcinomas (ITAC) are defined on the basis of their morphological similarities to colorectal adenocarcinomas (CRA). Thus, differential diagnosis with sinonasal metastasis of CRA could be a real challenge. Neuroendocrine differentiation has been variably described in several types of adenocarcinomas and notably in ITACs and CRAs. In a series of 25 ITACs and 25 lymph node metastasis of CRAs (nmCRA), we analysed neuroendocrine differentiation by immunohistochemistry with anti-chromogranin A and synaptophysin antibodies. Neuroendocrine differentiation (chromogranin A and/or synaptophysin positivity) was significantly different (p=0.0002) in ITACs (72%) and in nmCRAs (20%). In conclusion, presence of neuroendocrine cells seems more in favour of a sinonasal intestinal-type adenocarcinoma, than metastatic CRA. This immunohistochemical study could be useful in difficult cases and should be an interesting complement in a clinical discussion.

  • IMMUNOHISTOCHEMISTRY
  • HEAD AND NECK CANCER
  • Neuroendocrine

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