Prognostic Significance of Granuloma and Amyloid Deposition in Nasopharyngeal Carcinoma


The significance of granuloma and amyloid deposition in primary nasopharyngeal carcinoma (NPC) has yet to be investigated. This study aimed to evaluate their clinicopathologic associations. The histopathologic findings of 747 consecutive patients with primary NPC were retrospectively reviewed between January 2001 and December 2015. The presence of granulomas and amyloid deposits was observed in 68 (9.1%) and 62 (8.3%) patients, respectively. Granulomas were significantly associated with lower T classification, N classification, and overall TNM stage (p = 0.014, p = 0.006, and p = 0.001, respectively). Their presence was an independent predictor of overall survival (p = 0.033), disease-free survival (p = 0.034), and recurrence-free survival (p = 0.040). Conversely, amyloid deposition was not a predictor in any survival analyses. The present study demonstrated the prevalence of granuloma and amyloid deposition in the largest single institution cohort of primary NPC patients so far. Our results provide evidence that granulomas are significantly associated with better prognosis and treatment outcome. Further studies are needed to elucidate the mechanism of action of granuloma formation on the anti-tumor immunity of NPC.

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Data Availability

The data that support the findings of this study are available on request from the corresponding author.


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The authors thank all the members of the Cancer Center, Chang Gung Memorial Hospital, for their invaluable help.


This study was supported by a grant (MOST105-2628-B-182A-008-MY3) from the Ministry of Science & Technology and a grant (CMRPG2G0231) from Chang Gung Memorial Hospital, Keelung, Taiwan.

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YCL and LYL: Substantial contributions to the acquisition of data. Giving final approval of the version to be published. NMT: Analysis and interpretation of data. Giving final approval of the version to be published. CLH: Ensuring that questions related to the accuracy of the work are appropriately investigated and resolved. Giving final approval of the version to be published. LJH: Drafting and revising the manuscript critically. Giving final approval of the version to be published. TTK: Revising the manuscript for important intellectual content. Giving final approval of the version to be published. KPC: Substantial contributions to conception of the manuscript. Revising the manuscript critically for important intellectual content. Giving final approval of the version to be published.

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Correspondence to Kai-Ping Chang.

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Lee, Y., Lee, L., Tsang, N. et al. Prognostic Significance of Granuloma and Amyloid Deposition in Nasopharyngeal Carcinoma. Head and Neck Pathol (2020).

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  • Nasopharyngeal carcinoma
  • Radiotherapy
  • Head and neck
  • Granuloma
  • Amyloid