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Squamous cell carcinoma of the head and neck (view source)
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'''Squamous cell carcinoma of the head and neck''' is a common malignant epithelium neoplasm of the [[head and neck pathology|head and neck]]. | |||
The article deals only with the unclassified [[squamous cell carcinoma]] of the head and neck; HPV-associated SCC is dealt with in ''[[HPV-associated squamous cell carcinoma of the head and neck]]'' and nasopharyngeal carcinoma is dealt with in ''[[nasopharyngeal carcinoma]]''. | |||
==General== | |||
*Most common malignant tumour of the head & neck. | |||
*Most common spindle cell tumour of the head & neck. | |||
==Microscopic== | |||
===Classification=== | |||
SCC is subdivided by the WHO into:<ref name=Ref_Sternberg4_975>{{Ref Sternberg4|975}}</ref> | |||
*Keratinizing type (KT). | |||
**Worst prognosis. | |||
*Undifferentiated type (UT). | |||
**Intermediate prognosis. | |||
**EBV association. | |||
*Nonkeratinizing type (NT). | |||
**Good prognosis. | |||
**EBV association. | |||
Features based on classification:<ref name=Ref_Sternberg4_975>{{Ref Sternberg4|975}}</ref> | |||
*KT subtype: | |||
**Keratinization & intercellular bridges through-out most of the malignant lesion. | |||
*UT: | |||
**Non-distinct borders/syncytial pattern. | |||
**Nucleoli. | |||
*NT: | |||
**Well-defined cell borders. | |||
===Invasion=== | |||
Features: | |||
*Eosinophilia. | |||
*Extra large nuclei/bizarre nuclei. | |||
*Inflammation (lymphocytes, plasma cells). | |||
*Long rete ridges. | |||
*Numerous beeds/blobs of epithelial cells that seem unlikely to be rete ridges. | |||
Pitfalls: | |||
*Tangential cuts. | |||
**If you can trace the squamous cells from a gland to the surface it is less likely to be invasive cancer. | |||
Notes on invasion: | |||
*Nice review paper by ''Wenig''.<ref name=pmid11904340>{{cite journal |author=Wenig BM |title=Squamous cell carcinoma of the upper aerodigestive tract: precursors and problematic variants |journal=Mod. Pathol. |volume=15 |issue=3 |pages=229–54 |year=2002 |month=March |pmid=11904340 |doi=10.1038/modpathol.3880520 |url=http://www.nature.com/modpathol/journal/v15/n3/pdf/3880520a.pdf}}</ref> | |||
*See ''[[SCC of the cervix versus CIN III]]''. | |||
Image(s): | |||
*[http://commons.wikimedia.org/wiki/File:Oral_cancer_(1)_squamous_cell_carcinoma_histopathology.jpg?uselang=de Invasive oral SCC (WC)]. | |||
==Overview of subtypes== | |||
There are several subtypes:<ref>URL: [http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970297-2 http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970297-2]. Accessed on: March 9, 2010.</ref> | |||
*Basaloid - poor prognosis, usu. diagnosed by recognition of typical SCC. | |||
*Warty (Condylomatous). | |||
*Verrucous - good prognosis, rare. | |||
*Papillary. | |||
*Lymphoepithelial, rare. | |||
*Spindle cell, a common spindle cell lesion of the H&N. | |||
===Verrucous squamous cell carcinoma=== | |||
Features: | |||
*Exophytic growth. | |||
*Well-differentiated. | |||
*"Glassy" appearance. | |||
*Pushing border. | |||
DDx: papilloma. | |||
===Spindle cell squamous carcinoma=== | |||
*Key to diagnosis is finding a component of conventional squamous cell carcinoma. | |||
IHC: | |||
*Typically keratin -ve. | |||
*p63 +ve. | |||
DDx: | |||
*Spindle cell [[melanoma]]. | |||
*Mesenchymal neoplasm. | |||
===Basaloid squamous cell carcinoma=== | |||
*May mimic ''[[adenoid cystic carcinoma]]''. | |||
*Classically base of tongue.<ref>URL: [http://www.biomedcentral.com/1471-2407/6/146 http://www.biomedcentral.com/1471-2407/6/146]. Accessed on: March 9, 2010.</ref> | |||
*Typically poor prognosis. | |||
Features: | |||
*Need keratinization. (???) | |||
DDx: | |||
*Neuroendocrine tumour. | |||
===Lymphoepithelial (squamous cell) carcinoma=== | |||
See ''[[nasopharyngeal carcinoma]]''. | |||
==See also== | |||
*[[Head and neck pathology]]. | |||
*[[Squamous cell carcinoma]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Head and neck pathology]] | |||