Difference between revisions of "Squamous cell carcinoma of the head and neck"

From Libre Pathology
Jump to navigation Jump to search
(redirect)
 
(split out)
Line 1: Line 1:
#redirect [[Head_and_neck_pathology#Squamous_cell_carcinoma_of_the_head_and_neck]]
'''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]]

Revision as of 15:00, 25 February 2014

Squamous cell carcinoma of the head and neck is a common malignant epithelium neoplasm of the 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:[1]

  • Keratinizing type (KT).
    • Worst prognosis.
  • Undifferentiated type (UT).
    • Intermediate prognosis.
    • EBV association.
  • Nonkeratinizing type (NT).
    • Good prognosis.
    • EBV association.

Features based on classification:[1]

  • 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:

Image(s):

Overview of subtypes

There are several subtypes:[3]

  • 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

Features:

  • Need keratinization. (???)

DDx:

  • Neuroendocrine tumour.

Lymphoepithelial (squamous cell) carcinoma

See nasopharyngeal carcinoma.

See also

References

  1. ↑ 1.0 1.1 Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Oberman, Harold A; Reuter, Victor E (2004). Sternberg's Diagnostic Surgical Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 975. ISBN 978-0781740517.
  2. ↑ Wenig BM (March 2002). "Squamous cell carcinoma of the upper aerodigestive tract: precursors and problematic variants". Mod. Pathol. 15 (3): 229–54. doi:10.1038/modpathol.3880520. PMID 11904340. http://www.nature.com/modpathol/journal/v15/n3/pdf/3880520a.pdf.
  3. ↑ URL: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970297-2. Accessed on: March 9, 2010.
  4. ↑ URL: http://www.biomedcentral.com/1471-2407/6/146. Accessed on: March 9, 2010.
Retrieved from "https://librepathology.org/w/index.php?title=Squamous_cell_carcinoma_of_the_head_and_neck&oldid=29854"