A CLINICO-PATHOLOGICAL STUDY OF ADENOCARCINOMAS OF THE NASAL CAVITY AND PARANASAL SINUSES

Abstract

A adenocarcinoma arises rarely in the nasal cavity and paranasal sinus, 19 patients with this disease hospitalized in Shikoku Cancer Center Hospital were investigated.
They were five with colonic-type, three with adenosquamous cell-type, and twelve with adenocarcinomas derived from mucous duct. Three cases of benign adenomas, i.e. one mucous duct-type adenomas and two pleomorphic type were also studied as references.
In order to investigate the histological oncogenesis of adenocarcinomas, the histochemical studies were performed on the tissues in a comparison with those of squamous cell carcinomas.
The methods employed were routine H-E stain, PAS stain, Alcian blue stain as well as special stains of immunohistological method using ABC (avidin biotin peroxidase complex) method, to identify a localization of CEA and cytokeratin.
CEA was found to be localized at the apical surface with papillary or tubular shapes in colonic-type adenocarcinomas and adenosquamous carcinomas.
On the other hand the mucous epithelium of the ductal portion was positive for CEA on the ductal-type adenocarcinomas.
The positive localization of cytokeratin was found only in adenosquamous carcinoma and mucoepidermoid carcinoma, where squamous metaplasia of ductal epithelium was seen as the same pattern.
This study concluded that the nature of the apical membrane surface and squamous metaplasias, which were often seen in the nasal and paranasal mucosa, might become one of the causes in the developing the squamous cell carcinoma predominantly rather than adenocarcinoma in the nasal and paranasal sinuses.