A patient with nasopharyngeal carcinoma (NPC) is classified as WHO Type III. This histological subtype is associated with which aetiological agent and has the best response to radiotherapy?
- A Epstein-Barr virus (EBV) — undifferentiated non-keratinising carcinoma (lymphoepithelioma) ✓
- B HPV infection — undifferentiated non-keratinising carcinoma
- C Tobacco — keratinising SCC with cervical metastases
- D Familial genetic mutation — adenocarcinoma of the nasopharynx
Correct answer: A. Epstein-Barr virus (EBV) — undifferentiated non-keratinising carcinoma (lymphoepithelioma)
Explanation
WHO Type III NPC is undifferentiated non-keratinising carcinoma (also called lymphoepithelioma), strongly associated with Epstein-Barr virus infection in endemic areas (South China, Southeast Asia, North Africa). EBV DNA/EBER can be detected in tumour cells. This subtype has abundant lymphocytic infiltration and is exquisitely radiosensitive with the best locoregional control and overall survival among NPC subtypes. Plasma EBV DNA titres are used for monitoring treatment response and surveillance.
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.