Nonkeratinizing undifferentiated nasopharyngeal carcinoma: a case report

Nasopharyngeal carcinoma, a malignant neoplasm of squamous origin, is an uncommon neoplasm in the United States, although it is a significant cause of morbidity and mortality in southeast Asia and northern Africa. These lesions arise most frequently from the lateral wall of the nasopharynx and may be locally aggressive or metastasize regionally or distantly.

A 46-year-old African American male presented to our institution with a 5-month history of nasal congestion. Imaging studies revealed a mass filling the right sphenoid sinus and eroding into the adjacent sinuses and temporal bone. A biopsy was performed, and immediate imprint cytology showed two populations of cells, lymphoid cells and cohesive clusters of cells with prominent nucleoli. A diagnosis favoring nasopharyngeal carcinoma was rendered, and subsequent histology showed a nonkeratinizing undifferentiated nasopharyngeal carcinoma.

Nasopharyngeal carcinoma, particularly in its nonkeratinizing undifferentiated form, may mimic inflammatory and lymphoproliferative disorders. Careful examination for the distinct cytologic features is necessary for accurate diagnosis and subsequent treatment.