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

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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.

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Authors and Affiliations

  1. Department of Pathology, Cleveland Clinic Foundation, Robert J. Tomsich Pathology and Laboratory Medicine Institute, 9500 Euclid Avenue/L25, Cleveland, OH, 44195, USA

    Akeesha A. Shah

  2. ProPath Laboratories, 1355 River Bend Dr, Dallas, TX, 75247, USA

    Bahram Robert Oliai

  3. Department of Pathology, University of Texas Southwestern Medical Center, 5161 Harry Hines Blvd., Dallas, TX, 75390, USA

    Justin A. Bishop

Authors
  1. Akeesha A. Shah
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  2. Bahram Robert Oliai
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  3. Justin A. Bishop
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Correspondence to Akeesha A. Shah.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standard.

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Shah, A.A., Oliai, B.R. & Bishop, J.A. Consistent LEF-1 and MYB Immunohistochemical Expression in Human Papillomavirus-Related Multiphenotypic Sinonasal Carcinoma: A Potential Diagnostic Pitfall. Head and Neck Pathol 13, 220–224 (2019). https://doi.org/10.1007/s12105-018-0951-1

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  • DOI: https://doi.org/10.1007/s12105-018-0951-1

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