Histopathological Diagnosis of Nasopharyngeal Carcinoma: Looking beyond the Blue Book

Nasopharyngeal carcinoma (NPC) is a malignant tumour of the nasopharynx that has a strong geographical distribution, with a high incidence in Southern China. It is a tumour that has had many classification schemes proposed since the early 20th century. The latest classification proposed by the World Health Organization has two main types of tumour-nonkeratinizing carcinoma and keratinizing squamous cell carcinoma. In actual practice, however, histological gradations between these two types can be present and the prognostic significance of such subdivision remains unclear. As there has been an increasing trend of monitoring NPC by Epstein-Barr viral (EBV) load it is possible that future classifications may be based on whether the tumour is associated with EBV or not, rather than histological appearances.