Familial Nasopharyngeal Carcinoma 6

80 T. C. Putti and K-B. Tansections remains the cornerstone of NPC diagnosis,EBV encoded early RNA in situ hybridization (EBER-ISH) and cytokeratin immunohistochemistry are usefuladjuncts in diagnostically challenging cases.EBER-ISH is almost always positive in nonkeratinizingNPC, while it is negative in benign nasopharyngealepithelium and most other malignant differentialdiagnoses of NPC. Cytokeratin immunohistochemistryhelps highlight the irregular infiltrative nature ofNPC, contrasting with the regular surface and cryptalepithelium of normal biopsies. Malignant differentialdiagnoses that need to be distinguished from NPCinclude lymphoma, sinonasal carcinoma, and melanoma,while benign mimics include reactive lymphoidgerminal centers, crush artifacts, and postradiationchanges. 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