Nasopharyngeal carcinoma (NPC) is strongly associated with EBV infection. Which histological type has the STRONGEST association with EBV and the BEST prognosis with radiotherapy?
- A WHO Type IIb — non-keratinising undifferentiated carcinoma (lymphoepithelioma) ✓
- B WHO Type I — keratinising squamous cell carcinoma
- C WHO Type IIa — non-keratinising differentiated carcinoma
- D Basaloid SCC variant with p16 positivity
Correct answer: A. WHO Type IIb — non-keratinising undifferentiated carcinoma (lymphoepithelioma)
Explanation
WHO Type IIb (undifferentiated NPC, formerly called lymphoepithelioma) has the strongest association with Epstein-Barr virus and is the predominant subtype in endemic areas (Southeast Asia, Southern China). Paradoxically, undifferentiated NPC has the best radiation sensitivity and overall prognosis among NPC subtypes, with 5-year survival rates >70% for locoregionally confined disease. WHO Type I (keratinising SCC) has the weakest EBV association and the worst prognosis due to radio-resistance.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.