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Nasopharyngeal Cancers

Determining the Type of Nasopharyngeal Cancer

Only after a pathologist analyzes some cells or actual pieces of tissue from the lesion will your doctor be able to tell you if you have cancer. Your doctor and pathologist should specialize in head and neck cancers because some benign (non-cancerous) lesions can look like cancer on a small biopsy.

The World Health Organization divides nasopharynx cancer into three main types, depending on what the cells look like under the microscope. This separation is important because the prognosis can be quite different, depending on the type (under light microscopy).

  • WHO Type I (Keratinizing squamous cell carcinoma): These are similar to other squamous cell carcinomas and are typically well or moderately differentiated in terms of grade.
  • WHO Type II (Nonkeratinizing squamous cell carcinoma): These can look like squamous cell carcinomas in other non-head-and-neck sites. These can vary quite a bit in grade.
  • WHO Type III (Undifferentiated or poorly differentiated): These are a diverse group of NPCs seen in younger patients (and are actually the most common type). They can look like lymphomas under the microscope.

More rarely, other cancers can be found in the nasopharynx as well. Some of them include:

  • Salivary gland cancers: There are minor salivary glands located under the lining of the throat. This is why cancers that we typically see in salivary glands can arise in this region. They include diagnoses such as mucoepidermoid carcinomas, adenocarcinomas and adenoid cystic carcinomas, to name a few. See Salivary Gland Cancer for more information.
  • Lymphoma: The throat is lined with lymphoid cells. Some major sites of lymphoid tissue include the adenoids in the nasopharynx and palatine tonsils and lingual tonsils in the oropharynx. This is why lymphoma might appear as a lump in the throat area.
  • Mucosal melanoma: These cancers come from skin cells that give skin its color. In rare cases, melanoma can be found in the lining of the mouth, nose and/or throat.

Other extremely rare cancers of the nasopharynx include:

  • Sarcomas such as chondsarcoma, liposarcoma and synovial sarcoma
  • Malignant fibrous histiocytoma
  • Peripheral Neuroectodermal Tumor (PNET)
  • Cancer spread from another site
References

1 Ho JH. An epidemiologic and clinical study of nasopharyngeal carcinoma. International journal of radiation oncology, biology, physics. Mar-Apr 1978;4(3-4):182-198.

2 Hildesheim A, Levine PH. Etiology of nasopharyngeal carcinoma: a review. Epidemiologic reviews. 1993;15(2):466-485.

3 Vaughan TL, Shapiro JA, Burt RD, et al. Nasopharyngeal cancer in a low-risk population: defining risk factors by histological type. Cancer epidemiology, biomarkers & prevention: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. Aug 1996;5(8):587-593.

4 Xu FH, Xiong D, Xu YF, Cao SM, Xue WQ, Qin HD, Liu WS, Cao JY, Zhang Y, Feng QS, Chen LZ, Li MZ, Liu ZW, Liu Q, Hong MH, Shugart YY, Zeng YX, Zeng MS, Jia WH. An epidemiological and molecular study of the relationship between smoking, risk of nasopharyngeal carcinoma, and Epstein-Barr virus activation. J Natl Cancer Inst. 2012 Sep.

5 Pelucchi C, Gallus S, Garavello W, Bosetti C, La Vecchia C. Cancer risk associated with alcohol and tobacco use: focus on upper aero-digestive tract and liver. Alcohol research & health: the journal of the National Institute on Alcohol Abuse and Alcoholism. 2006;29(3):193-198.

6 Buell P. The effect of migration on the risk of nasopharyngeal cancer among Chinese. Cancer research. May 1974;34(5):1189-1191.

7 Yu, et al. Cantonese-style salted fish as a cause of nasopharyngeal carcinoma: a report of a case-control study in Hong Kong. Cancer Res. 1986;46:956-961.

8 zur Hausen, et al. EBV DNA in biopsies of Burkitt tumors and anaplastic carcinomas of the nasopharynx. Nature. 1970;228:1056-1058.

9 Henle G, et al. EBC specific IgA serum antibodies as an outstanding feature of nasopharyngeal carcinoma. Int J Cancer. 1976;17;1-17.

10 Yu MC, et al. Occupational and other non-dietary risk factors for NPC in Guangzhou, China. Int J Cancer. 1990;45:1033-1039.

11 Morris RE, Mahmeed BE, Gjorgov AN, Jazzaf HG, Rashid BA. The epidemiology of lip, oral cavity and pharyngeal cancers in Kuwait 1979-1988. The British journal of oral & maxillofacial surgery. Aug 2000;38(4):316-319.

12 Decker J, Goldstein JC. Risk factors in head and neck cancer. The New England journal of medicine. May 13 1982;306(19):1151-1155.

13 Sham JS, et al. serous otitis media. An opportunity for early recognition of nasopharyngeal carcinoma. Arch Otolaryngol Head Neck Surg. 1992;118:794-797.

14 Neel HB, 3rd. Nasopharyngeal carcinoma: diagnosis, staging, and management. Oncology (Williston Park). Feb 1992;6(2):87-95; discussion 99-102.

15 Wei WI, Sham JS. Nasopharyngeal carcinoma. Lancet. Jun 11-17 2005;365(9476):2041-2054.

16 Sham JST, Cheung YK, Chan FL, Choy D. Nasoparyngeal carcinoma: pattern of skeletal metastases. Br J Radiol. 1990;63:202-205.

17 Spiro RH, Thaler HT, Hicks WF, Kher UA, Huvos AH, Strong EW. The importance of clinical staging of minor salivary gland carcinoma. Am J Surg. 1991 Oct;162(4):330-6.

18 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 7, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.

19 Piccirillo JF, Costas I, Reichman ME. Chapter 2: Cancers of the Head and Neck. Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.

20 Edge SB, et al. The AJCC Cancer Staging Manual – Seventh Edition. American Joint Committee on Cancer 2010.