Squamous cell carcinoma of unknown primary localization: isolated lesion of cervical lymph nodes.

O. V. Poslavska, I. S. Shponka

Abstract


Cancers of unknown primary localization (CUPL) are a heterogeneous group of metastatic neoplasias for which a standardized diagnostic examination did not determine the primary localization of the origin. In 5% of histological form of CUPL is squamous cell carcinoma, which, in the case of an isolated lesion of the cervical lymph nodes is treated as a "favorable phenotype". Tactics of treatment of such a CUPL is suggested in both primary local squamous cell carcinoma (SCC) of the, head and neck with regional lymph nodes involvement (T1-3N1-3M0) and in 25% -30% of patients leads to a 5-years survival rate. This calls for the use of an immunohistochemical method for the accurate verification of the histological form of an isolated metastasis of the cervical lymph nodes and use of the appropriate therapy. In the work 62 samples of isolated lesions of the cervical lymph nodes with carcinomas without another established primary localization for the period 2015-2017 were investigated. The control group consisted of 12 samples of SCC of the head and neck of the known localizations. The immunohistochemical panel of markers included Cytokeratin Pan, Vimentin, CD45, S100, Cytokeratin HMW, Cytokeratin 7, Cytokeratin 20, p63, TTF1. The parameters of the areas, perimeters and “roundness” of the nucleus were determined in the ImageJ pro­gram. The aim of the study was to investigate the complex of morphological, morphometric and immunohistochemical characteristics of SCC without primary localization with isolated lesion of the cervical lymph nodes, in comparison with other histological forms and control group of SCC of the head and neck of the known localizations to improve diagnostic algorithms. A difference in the distribution of histological forms for all CUPL with isolated lesion of the cervical lymph nodes was determined in the predominance of SCC, in comparison with the general distribution of histological forms for all CUPL. Similarity of morphometric parameters of metastatic SCC of subgroup 1 (phenotype of Cytokeratin, Pan AE1 / AE3 (+) / Cytokeratin HMW (+) / p63 (+) / Cytokeratin 20 (-) / TTF1 (-) / Vimentin (- / +) / Cytokeratin 7 (- / +)) with samples of the control group of SCC of the head and neck of known localizations. The es­tablished decrease in the size and "roundness ratio" of the nuclei of the SCC cells is a reflection of the weighting of cellular atypia and correlates with the polymorphism of the nuclei and decrease in the degree of differentiation of the SCC.

Keywords


CUT; squamous cell carcinoma; lymph nodes of the neck; ImageJ

References


Poslavska OV, Shponka IS, Hritsenko PA, Alek­seenko OA. [Morphometric analysis of “pancytokeratin-positive” neoplastic lesions of the lymph nodes of the neck]. Pathologia. 2017;14(3):287-92. Ukrainian.

Poslavska OV, Shponka IS, GritsenkoPO, Alek­seenko OA. [Morphometric analysis of pancytokeratin-negative neoplastic damages of the lymphatic nodes of the neck]. Medicni perspektivi. 2018;23(1):30-37. Ukrainian.

Poslavskaya OV. [Determination of linear dimen­sions and squares surfaces areas of morphological objects on micrographs using ImageJ software]. Morpho­logia. 2016;10(3):377-81. Ukrainian.

Greco FA. Molecular diagnosis of the tissue of ori­gin in cancer of unknown primary site: useful in patient ma­nagement. Curr Treat Options Oncol. 2013;14(4):634-42.

Vajdic CM, Schaffer AL, Dobbins TA, Ward RL, Er CC, Pearson SA. Health service utilisation and in­vestigations before diagnosis of cancer of unknown primary (CUP): A population-based nested case-control study in Australian Government Department of Veterans' Affairs clients. Cancer Epidemiol. 2015;39(4):585-92.

Lin F, Haiyan Liu. Immunohistochemistry in Un­differentiated Neoplasm / Tumor of Uncertain Origin. Arch Pathol Lab Med. 2014;138:1583-610.

Pavlidis N, Pentheroudakis G. Cancer of un­known primary site. The Lancet. 2012;379(9824):1428-35.

Hemminki K, Bevier M, Hemminki A, Sundquist J. Survival in cancer of unknown primary site: popu­lation-based analysis by site and histology. Ann Oncol. 2012;23:1854-63.

Vajdic CM, Goldstein D. Cancer of unknown primary site. Aust Fam Physician. 2015;44(9):640-3.


GOST Style Citations


  1. Морфометричний аналіз «панцитокератин-по­зитивних» неопластичних уражень лімфатичних вуз­лів шиї / О.В. Пославська, І.С. Шпонька, П.О. Гри­ценко, О.А. Алєксєєнко // Патологія. – 2017. – Т. 14, № 3(41). – С. 287-292.
  2. Морфометричний аналіз панцитокератин-не­гативних неопластичних ушкоджень лімфатичних вузлів шиї / О.В. Пославська, І.С. Шпонька, П.О. Гри­ценко, О.А. Алексєєнко // Медичні перспективи. – 2018. – Т. 23, № 1. – С. 30-37.
  3. Пославська О.В. Визначення лінійних розмірів та площ окремих морфологічних об’єктів на мікро­фото­графіях за допомогою програми ImageJ / О.В. Пос­лавська // Морфологія. – 2016. – Т. 10, № 3. – С. 377-381.
  4. Greco F.A. Molecular diagnosis of the tissue of origin in cancer of unknown primary site: useful in patient management / F.A. Greco // Curr. Treat Options Oncol. – 2013. – Vol. 14, N 4. – P. 634-642.
  5. Health service utilisation and investigations be­fore diagnosis of cancer of unknown primary (CUP): A population-based nested case-control study in Australian Government Department of Veterans' Affairs clients / C.M. Vajdic, A.L. Schaffer, T.A. Dobbins [et al.] // Cancer Epidemiol. – 2015. – Vol. 39, N 4. – P. 585-592.
  6. Lin F. Immunohistochemistry in Undifferentiated Neoplasm / Tumor of Uncertain Origin / Fan Lin, Haiyan Liu // Arch. Pathol. Lab Med. – 2014. – Vol. 138. – Р. 1583-1610.
  7. Pavlidis N. Cancer of unknown primary site /N. Pavlidis, G. Pentheroudakis // Lancet. 2012. – Vol. 379, N 9824. – P. 1428-1435.
  8. Survival in cancer of unknown primary site: po­pulation-based analysis by site and histology / K. Hem­minki, M. Bevier, A. Hemminki, J. Sundquist // Ann Oncol. – 2012. – Vol. 23. – P. 1854-1863.
  9. Vajdic C.M. Cancer of unknown primary site / C.M. Vajdic, D. Goldstein  // Aust. Fam. Physician. – 2015. – Vol. 44, N 9, – P. 640-643.




DOI: https://doi.org/10.26641/2307-0404.2018.2.133692

Refbacks

  • There are currently no refbacks.