Article Text

Download PDFPDF

1 Tumour associated macrophages in HPV-related carcinoma with adenoid cystic like features of the sinonasal tract; a review of three cases
  1. Kasimu Adoke1,
  2. Jonathan Madukwe2 and
  3. Faruk Mohammed3
  1. 1Department of Pathology Federal Medical Center Bir, Kebbi, Nigeria
  2. 2Department of Pathology, NH Abuja, Abuja, Nigeria
  3. 3Department of pathology ABU, Zaria, Nigeria


Background HPV- related carcinoma with adenoid cystic like features of the sinonasal tract is a newly describe entity with histological and immunophenotypic features of surface derived and salivary gland carcinoma. It affects females more than males with age range of 40–70 years and is linked to high risk HPV infection. Most cases present with nasal obstruction and epistaxis. They consist of basaoid cells growing in various sizes separated by fibrocollagenous stroma.1 It is believed to have a good prognosis. Tumor-associated macrophages (TAMs) are activated macrophages associated with tumor progression in various cancers. TAMs can polarize M1 or M2 type. M1 has a pro-inflammatory function and kills pathogens. Conversely, M2 shows immunosuppressive action and promotes tumor growth. CD68 is known as a pan-macrophage marker.2 We evaluate the CD68 expression in three cases of HPV- related carcinoma with adenoid cystic like features of the sinonasal tract.

Methods Three cases of HPV-related carcinoma with adenoid cystic like features were retrieved from our archives and stained with p16 and CD68 antibodies. Data was analyzed using spss version 21.

Results Patient ages were 46, 48 and 56 years old respectively, with a female to male ratio of 2:1. Histology showed epithelial surface dysplasia overlying basaloid cell growing in tubular and crbriform patterns. All were strongly positive for p16 stains (figure 1). CD 68 showed intratumoral and peritumoral expression in two cases while, one case showed only peritumoral expression. Infiltration of tumour associated macrophages (M2) CD68 cell in this study is associated with increase recurrence of HPV-related adenoid cystic carcinoma of the sinonasal tract (figure 2).

Abstract 1 Figure 1

p16 staining in HPV- related adenoid cystic carcinoma of the sinonasal tract

Abstract 2 Figure 2

CD 68 staining of the stroma in HPV-related adenoid cystic carcinoma of sinonasal tract

Conclusions The targeting of TAMs in HPV-related adenoid cystic carcinoma of the sinonasal tract and other cancers should be explored in the future using macrophage targeted approach.

Ethics Approval Health research ethics committee ABUTH/HREC/Y/2017


  1. Burugu S, Asleh-Aburaya K, Nielsen TO. Immune infiltrates in the breast cancer microenvironment: detection, characterization and clinical implication. Breast Cancer 2017; 24:3–15.

  2. Fan QM, Jing YY, Yu GF, Kou XR, Ye F, Gao L, Li R, Zhao QD, Yang Y, Lu ZH, Wei LX. Tumor-associated macrophages promote cancer stem cell-like properties via transforming growth factor-beta1-induced epithelial-mesenchymal transition in hepatocellular carcinoma. Cancer Lett 2017;352:160–168.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.