APPORT DE L’ANATOMIE PATHOLOGIQUE DANS LE CANCER DU CAVUM

Objectives : Nasopharyngeal cancers account for 45% of all ear-nose and throat cancers at the National Institute of Oncology (cancer registry). Carcinomas are by fare the most frequent with the particularity of beying tighly link to the presence of Epstein-barr virus, sensitive to radiation therapy and lymphophilic revealed by cervical masses in 40% of the cases. A precise and reliable anatomo pathological diagnosis is therefore mandatory before initiating any treatment. Methods and results : The authors report the results of histopathologic techniques (routine and special stains, immunohistochemistry) in the diagnosis of 143 biopsies of the rhinopharynx with a frequency of undifferenciated carcinoma of the nasopharynx (UCNT). All biopsies of suspicion of relapse were inflammatory corresponding to mycotsic inflammation in half of the cases. A special mention is made of the conclusive contribution of in situ hybridization on paraffin sections in positive and differentiel diagnosis in regard to the results described in the litterature. Conclusion : Therefore, in the particular context of nasopharynx cancer -frequent in our country, sensitive to radiation therapy but with possible relapses-, the authors emphasis on the specific utility, besides basic and special stainings and immunohistochemistry, of in situ hybridization on paraffin sections, to search for the presence of Epstein-barr virus particles in tumoral cells. This technique should, indeed, be used as reliable routine technique allowing positive diagnosis of relapses and differential diagnosis in the cases of cervical masses without a known primary site and an extensive cancer of the rhinopharyngeal and sinonasal regions.