Difference between revisions of "Human papillomavirus-associated head and neck squamous cell carcinoma"

From Libre Pathology
Jump to navigation Jump to search
(→‎General: more)
Line 39: Line 39:
*Tumours associated with high risk HPV, typically [[HPV]] 16.<ref name=pmid22001331 >{{Cite journal  | last1 = Wang | first1 = XI. | last2 = Thomas | first2 = J. | last3 = Zhang | first3 = S. | title = Changing trends in human papillomavirus-associated head and neck squamous cell carcinoma. | journal = Ann Diagn Pathol | volume = 16 | issue = 1 | pages = 7-12 | month = Jan | year = 2012 | doi = 10.1016/j.anndiagpath.2011.07.003 | PMID = 22001331 }}</ref>
*Tumours associated with high risk HPV, typically [[HPV]] 16.<ref name=pmid22001331 >{{Cite journal  | last1 = Wang | first1 = XI. | last2 = Thomas | first2 = J. | last3 = Zhang | first3 = S. | title = Changing trends in human papillomavirus-associated head and neck squamous cell carcinoma. | journal = Ann Diagn Pathol | volume = 16 | issue = 1 | pages = 7-12 | month = Jan | year = 2012 | doi = 10.1016/j.anndiagpath.2011.07.003 | PMID = 22001331 }}</ref>
**Thought to be different that tumours driven by [[alcohol]] and [[smoking|tobacco]] use.<ref name=pmid21769577>{{Cite journal  | last1 = Wittekindt | first1 = C. | last2 = Wagner | first2 = S. | last3 = Klussmann | first3 = JP. | title = [HPV-associated head and neck cancer. The basics of molecular and translational research]. | journal = HNO | volume = 59 | issue = 9 | pages = 885-92 | month = Sep | year = 2011 | doi = 10.1007/s00106-011-2357-1 | PMID = 21769577 }}</ref>
**Thought to be different that tumours driven by [[alcohol]] and [[smoking|tobacco]] use.<ref name=pmid21769577>{{Cite journal  | last1 = Wittekindt | first1 = C. | last2 = Wagner | first2 = S. | last3 = Klussmann | first3 = JP. | title = [HPV-associated head and neck cancer. The basics of molecular and translational research]. | journal = HNO | volume = 59 | issue = 9 | pages = 885-92 | month = Sep | year = 2011 | doi = 10.1007/s00106-011-2357-1 | PMID = 21769577 }}</ref>
***Patients tend to be male and slightly younger - risk thought to be due to sexual practices.<ref name=pmid22046680>{{Cite journal  | last1 = Vourexakis | first1 = Z. | last2 = Dulguerov | first2 = P. | title = [HPV associated head and neck cancers]. | journal = Rev Med Suisse | volume = 7 | issue = 311 | pages = 1919-22 | month = Oct | year = 2011 | doi =  | PMID = 22046680 }}</ref>
***Patients tend to be male (male:female = 5:1<ref name=pmid26483987>{{Cite journal  | last1 = Ajila | first1 = V. | last2 = Shetty | first2 = H. | last3 = Babu | first3 = S. | last4 = Shetty | first4 = V. | last5 = Hegde | first5 = S. | title = Human Papilloma Virus Associated Squamous Cell Carcinoma of the Head and Neck. | journal = J Sex Transm Dis | volume = 2015 | issue =  | pages = 791024 | month =  | year = 2015 | doi = 10.1155/2015/791024 | PMID = 26483987 }}</ref>) and slightly younger - risk thought to be due to sexual practices.<ref name=pmid22046680>{{Cite journal  | last1 = Vourexakis | first1 = Z. | last2 = Dulguerov | first2 = P. | title = [HPV associated head and neck cancers]. | journal = Rev Med Suisse | volume = 7 | issue = 311 | pages = 1919-22 | month = Oct | year = 2011 | doi =  | PMID = 22046680 }}</ref>
*Lesions more radiosensitive and usually have a better prognosis.<ref name=pmid22001331/>
*Lesions more radiosensitive and usually have a better prognosis.<ref name=pmid22001331/>


Revision as of 19:33, 7 March 2016

Human papillomavirus-associated head and neck squamous cell carcinoma
Diagnosis in short

Poorly differentiated squamous cell carcinoma (SCC) that is p16 positive, compatible with HPV-associated head and neck SCC. H&E stain.
LM typically non-keratinizing squamous cell carcinoma
LM DDx squamous dysplasia of the head and neck, squamous cell carcinoma of the head and neck, nasopharyngeal carcinoma
IHC p16 +ve, EBV-ve, p63 +ve, CK5/6 +ve
Molecular EBER -ve
Gross palatine tonsil, lingual tonsil, oropharynx
Site head and neck
Clinical history typically male, younger than typical H&N SCC, +/-homosexual practices
Prevalence uncommon
Prognosis good compared to usu. head and neck SCC

Human papillomavirus-associated head and neck squamous cell carcinoma, abbreviated HPV-associated SCC and HPV-NHSCC, is a type of head and neck squamous cell carcinoma.

It has a unique epidemiology, when compared to conventional head and neck squamous cell carcinoma.

Human papillomavirus-associated head and neck cancer redirects here.

General

  • Tumours associated with high risk HPV, typically HPV 16.[1]
    • Thought to be different that tumours driven by alcohol and tobacco use.[2]
      • Patients tend to be male (male:female = 5:1[3]) and slightly younger - risk thought to be due to sexual practices.[4]
  • Lesions more radiosensitive and usually have a better prognosis.[1]

Gross

Classic locations:

  • Tonsil and base of tongue[5] (palatine tonsil, lingual tonsil, oropharynx).

Note:

  • Memory device:
    • Where the tip of the penis goes when someone is deep throating.

Microscopic

Features:[6]

  • Typically non-keratinizing squamous cell carcinoma.

DDx:

Images

  • SCC p16 positive - very low mag.

  • SCC p16 positive - low mag.

  • SCC p16 positive - intermed. mag.

  • SCC p16 positive - intermed. mag.

  • SCC p16 positive - high mag.

  • SCC p16 positive - very high mag.

www:

IHC

  • p16 +ve.[5]
  • EBV -ve.
  • CK5/6 +ve.
  • p63 +ve.

Molecular

  • EBER -ve.

Sign out

BASE OF LEFT TONSIL, BIOPSY:
- INVASIVE SQUAMOUS CELL CARCINOMA, POORLY DIFFERENTIATED, SEE COMMENT.

COMMENT:
The tumour is p16 positive and EBV negative; this favours a HPV-associated 
squamous cell carcinoma. Clinical correlation is suggested.

The tumour stains as follows:
POSITIVE: p63, CK5/6, BCL2.
NEGATIVE: LCA, EBV, synaptophysin, chromogranin, CD56.
PROLIFERATION (Ki-67): 90% of tumour cells.

See also

References

  1. ↑ 1.0 1.1 Wang, XI.; Thomas, J.; Zhang, S. (Jan 2012). "Changing trends in human papillomavirus-associated head and neck squamous cell carcinoma.". Ann Diagn Pathol 16 (1): 7-12. doi:10.1016/j.anndiagpath.2011.07.003. PMID 22001331.
  2. ↑ Wittekindt, C.; Wagner, S.; Klussmann, JP. (Sep 2011). "[HPV-associated head and neck cancer. The basics of molecular and translational research].". HNO 59 (9): 885-92. doi:10.1007/s00106-011-2357-1. PMID 21769577.
  3. ↑ Ajila, V.; Shetty, H.; Babu, S.; Shetty, V.; Hegde, S. (2015). "Human Papilloma Virus Associated Squamous Cell Carcinoma of the Head and Neck.". J Sex Transm Dis 2015: 791024. doi:10.1155/2015/791024. PMID 26483987.
  4. ↑ Vourexakis, Z.; Dulguerov, P. (Oct 2011). "[HPV associated head and neck cancers].". Rev Med Suisse 7 (311): 1919-22. PMID 22046680.
  5. ↑ 5.0 5.1 Heath, S.; Willis, V.; Allan, K.; Purdie, K.; Harwood, C.; Shields, P.; Simcock, R.; Williams, T. et al. (Feb 2012). "Clinically significant human papilloma virus in squamous cell carcinoma of the head and neck in UK practice.". Clin Oncol (R Coll Radiol) 24 (1): e18-23. doi:10.1016/j.clon.2011.05.007. PMID 21752613.
  6. ↑ Chernock, RD.; El-Mofty, SK.; Thorstad, WL.; Parvin, CA.; Lewis, JS. (Sep 2009). "HPV-related nonkeratinizing squamous cell carcinoma of the oropharynx: utility of microscopic features in predicting patient outcome.". Head Neck Pathol 3 (3): 186-94. doi:10.1007/s12105-009-0126-1. PMC 2811624. PMID 20596971. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811624/.
Retrieved from "https://librepathology.org/w/index.php?title=Human_papillomavirus-associated_head_and_neck_squamous_cell_carcinoma&oldid=42910"