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Sinunasale Karzinome nach Holzstaubbelastung

Morphologisches Spektrum an 160 Fällen

  • Schwerpunkt: Orale Pathologie/Pathologien der Speicheldrüsen—Originalarbeit
  • Published:
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Zusammenfassung

Sinunasale Tumoren sind meistens Plattenepithelkarzinome oder Transitionalzellkarzinome. Die seltenen Adenokarzinome der inneren Nase und der Nasennebenhöhlen zeigen eine Korrelation zu einer Holzstaubbelastung. Dies trifft allerdings nur für Adenokarzinome vom intestinalen Typ zu und nicht für Speicheldrüsenkarzinome oder polymorphe Low-grade-Adenokarzinome. Unter 160 Fällen mit Holzstaubanamnese und Malignomen der inneren Nase fanden sich 134 sinunasale Adenokarzinome vom intestinalen Typ (SNAIT) und 24 andere Karzinome sowie ein malignes Melanom und ein malignes Synovialom. Die SNAIT zeigen verschiedene Subtypen mit hoher morphologischer Ähnlichkeit zu kolorektalen Adenokarzinomen (papillär-tubulär: 72,4%; alveolär-becherzellig 5,2%, siegelringzellig 3,7%, Übergangsformen 18,7%). Hochdifferenzierte Adenokarzinome (G1) sind mit 23,1% und muzinöse Adenokarzinome mit 29,1% relativ häufig. Als kanzerogene Faktoren werden neben Holzstaub auch Holzadditive diskutiert. Bei der Entwicklung von SNAIT ist eine Metaplasie-Dysplasie-Carcinoma-in-situ-Sequenz wahrscheinlich. Bei symptomarmem klinischem Verlauf tritt eine Erstmanifestation der Tumoren häufig im fortgeschrittenen Stadium auf.

Abstract

Sinonasal carcinomas are usually of the squamous cell or transitional cell type. Adenocarcinomas of the inner nose and the paranasal sinus correlate with exposure to wood dust. However, this is only true for adenocarcinomas of the intestinal type and not for salivary gland carcinomas or polymorphous low-grade adenocarcinomas. Of 160 cases with a history of wood dust exposure and malignant tumors of the inner nose, 134 were sinonasal adenocarcinomas of the intestinal type (SNAIT). In addition, there were 24 other carcinomas as well as 1 malignant melanoma and 1 malignant synovial tumor. The SNAIT showed various subtypes with great morphological similarities to colorectal adenocarcinomas (papillary tubular cylinder cell: 72.4%; alveolar goblet cell: 5.2%; signet ring cell: 3.7%; transitional type: 18.7%). Highly differentiated adenocarcinomas (G1) and mucinous adenocarcinomas were relatively frequent: they accounted for 23.1% and 29.1% of the 134 SNAIT, respectively. Apart from wood dust, wood additives are discussed as a carcinogenic factor. With the development of SNAIT, a metaplasia–dysplasia–carcinoma in situ sequence is probable. If the clinical course shows few symptoms, the first manifestation of such a tumor often occurs in an advanced stage.

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Authors and Affiliations

  1. Institut für Pathologie, Klinikum Braunschweig

    K. Donhuijsen & S. Hattenberger

  2. HNO-Klinik, Klinikum Braunschweig

    H. G. Schroeder

  3. Institut für Pathologie, Klinikum Braunschweig, Celler Straße 38, 38114 , Braunschweig

    K. Donhuijsen

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  1. K. Donhuijsen
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  2. S. Hattenberger
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  3. H. G. Schroeder
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Correspondence to K. Donhuijsen.

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Donhuijsen, K., Hattenberger, S. & Schroeder, H.G. Sinunasale Karzinome nach Holzstaubbelastung. Pathologe 25, 14–20 (2004). https://doi.org/10.1007/s00292-003-0668-z

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