pathology
Last reviewed 01/2022
Nasopharyngeal carcinoma is a lymphoepithelioma comprising lymphoid elements admixed with malignant epithelial cells identical to those of a poorly differentiated squamous cell carcinoma. The epithelial cells, not the lymphoid elements, are considered neoplastic.
Biopsy is necessary to differentiate nasopharyngeal carcinoma from other nasopharyngeal malignancies, such as:
- lymphoma - including Burkitt's lymphoma
- sarcoma - rhabdomyosarcoma, sarcomas from fibrous, cartilaginous, or osseous tissues surrounding the nasopharynx
- adenocarcinoma
- tumours from salivary tissues - such as adenoid cystic adenocarcinoma
Spread may occur:
- directly:
- anteriorly, i.e. nasally
- inferiorly, i.e. pharyngeal
- superiorly, i.e. sphenoidal
- posteriorly, i.e. region of first cervical vertebra
- laterally, i.e. parotid gland; IX, X, XI, XII cranial nerves
- lymphatic - to the upper deep cervical lymph nodes
- haematogenous - to the spinal column, lung and liver
Lymphatic spread tends to occur earliest.