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Int J Clin Exp Pathol 2011;4(4):410-415

Case Report
Paucilymphoid non-keratinizing nasopharyngeal carcinoma with prominent stromal
desmoplasia – an unusual case reported with brief comments on uncommon histological

Fredrik Petersson, Kwok Seng Loh, Diana Lim

Department of Pathology, National University Health System, Singapore; Department of Otolaryngology, Head & Neck Surgery, National
University Health System, Singapore.

Received February 20, 2011; accepted March 21, 2011; Epub April 3, 2011; published April 30, 2011

Abstract: We present a case of de novo non-keratinizing carcinoma of the nasopharynx (NK-NPC) with an unusual combination of histological
features; (1) a minimal associated component of reactive lymphoplasmacytic cells and (2) a prominent desmoplastic stromal response. Apart
from the unusual histologic features, this case did not display any unusual clinical or radiological features. On immunohistochemistry the
tumor cells were strongly positive for cytokeratins (AE1-3 and 5/6) and p63 and there was strong and diffuse nuclear positivity for EBV on in situ
hybridization. Since no external factor could be attributed to the conspicuous paucity of associated lymphoid cells, we feel that this may be due
to inherent features of the neoplasm itself. This case highlights the histomorphological variability of NK-NPC. Awareness of the histological
spectrum of NK-NPC is important in clinical practice and this is not always adequately highlighted in currently used standard textbooks of head
and neck pathology. (IJCEP1102003).

Keywords: Nasopharynx, carcinoma, fibrosis, fibroplasia, desmoplasia

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Address all correspondence to:
Fredrik Petersson MD, PhD
Department of Pathology
National University Health System
5 Lower Kent Ridge Road
Singapore 119074
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