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2014/10/23 7

Nasopharyngeal carcinoma

. Nasopharyngeal carcinoma
()

nasopharyngeal cancer(e.g. lymphoma,

adenocarcinoma)

()

. P.125
.

()

Nasopharyngeal subsites (AJCC staging)

1.

Superior & posterior wall

2.

Lateral wall
(1) Extends from the base of skull of each side to the level of free border

of soft palate.
(2) Fossa of Rosenmller
(3) Torus tubarius
()

Waldeyers ring tonsil ring

.
()

()

PE (lymph node levels)

1.

Parotid gland

2.

Submandibular gland

3.

Level I ~ VI
(1) level II, III

()

IgA
1.

Anti-VCA(viral capsid antigen)high sensitivity, low specificity

2.

Anti-EA (early antigen)

positive

()

3.

Anti-DNAse

4.

Anti-NA (nuclear antigen)

()

MRI CT

Etiology
. Epstein-Barr virus-related P.129~130
. Genetic factor
()

5.8~19%

()

Mutations, e.g. p53, Bcl-2

. Risk factors

()

e.g. marinated food, smoking, formaldehyde, sawdust, air pollution

()

risk factor

Symptom
. (Neck mass)
3

 70~80%

. (Blood-tinged nasal discharge)

. (Nasal obstruction)

. (Aural symptom)

. (Headache)

. (Cranial nerve neuropathy)


()

CN VI
CN III, IV

()

CN V

()

CN X, XII

. Metastasis
()

P.136

()

(WHO classification)
. Type 1 (I): Keratinizing squamous cell carcinoma

. Type 2a (II): Non-keratinizing squamous cell carcinoma

. Type 2b (III): Undifferentiated or poorly differentiated carcinoma including

lymphoepithelioma and anaplastic variants

90%