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Sinonasal non-intestinal-type adenocarcinoma (non-ITAC) is a rare, morphologically diverse neoplasm of the head and neck. Squamoid morular metaplasia has recently been reported as an occasional finding in non-ITAC. Interestingly, these squamoid morules often show aberrant expression of CDX2 as well as nuclear expression of  β -catenin, similar to other tumors that show this type of metaplasia, but the underlying mechanism responsible for this finding is not completely understood. We present two cases of low-grade non-ITAC with squamoid morules coexpressing CDX2 and nuclear  β -catenin by immunohistochemistry, both of which were found to harbor a mutation in  CTNNB1 , the gene encoding  β -catenin. This finding provides support that an alteration in the  β -catenin pathway, including mutations in the  β -catenin gene itself, is responsible for this recently described morphologic phenomenon in non-ITAC.

case reports in pathology

Two Cases of Sinonasal Non-Intestinal-Type Adenocarcinoma with Squamoid Morules Expressing Nuclear <i>β</i>-Catenin and CDX2: A Curious Morphologic Finding Supported by Molecular Analysis

Two Cases of Sinonasal Non-Intestinal-Type Adenocarcinoma with Squamoid Morules Expressing Nuclear β-Catenin and CDX2: A Curious Morphologic Finding Supported by Molecular Analysis