Difference between revisions of "Squamous cell carcinoma of the head and neck"
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*[http://commons.wikimedia.org/wiki/File:Oral_cancer_(1)_squamous_cell_carcinoma_histopathology.jpg?uselang=de Invasive oral SCC (WC)]. | *[http://commons.wikimedia.org/wiki/File:Oral_cancer_(1)_squamous_cell_carcinoma_histopathology.jpg?uselang=de Invasive oral SCC (WC)]. | ||
==Overview of subtypes== | ===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> | 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. | *Basaloid - poor prognosis, usu. diagnosed by recognition of typical SCC. | ||
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*Spindle cell, a common spindle cell lesion of the H&N. | *Spindle cell, a common spindle cell lesion of the H&N. | ||
===Verrucous squamous cell carcinoma=== | ====Verrucous squamous cell carcinoma==== | ||
Features: | Features: | ||
*Exophytic growth. | *Exophytic growth. | ||
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DDx: papilloma. | DDx: papilloma. | ||
===Spindle cell squamous carcinoma=== | ====Spindle cell squamous carcinoma==== | ||
*Key to diagnosis is finding a component of conventional squamous cell carcinoma. | *Key to diagnosis is finding a component of conventional squamous cell carcinoma. | ||
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*Mesenchymal neoplasm. | *Mesenchymal neoplasm. | ||
===Basaloid squamous cell carcinoma=== | ====Basaloid squamous cell carcinoma==== | ||
*May mimic ''[[adenoid cystic 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> | *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> | ||
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*Neuroendocrine tumour. | *Neuroendocrine tumour. | ||
===Lymphoepithelial (squamous cell) carcinoma=== | ====Lymphoepithelial (squamous cell) carcinoma==== | ||
See ''[[nasopharyngeal carcinoma]]''. | See ''[[nasopharyngeal carcinoma]]''. | ||
Revision as of 15:07, 25 February 2014
Squamous cell carcinoma of the head and neck, abbreviated head and neck SCC, is a common malignant epithelium neoplasm of the head and neck.
The article deals only with the usual squamous cell carcinoma of the head and neck; the HPV-associated SCC is dealt with in HPV-associated head and neck squamous cell carcinoma 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:
- Nice review paper by Wenig.[2]
- See SCC of the cervix versus CIN III.
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
- May mimic adenoid cystic carcinoma.
- Classically base of tongue.[4]
- Typically poor prognosis.
Features:
- Need keratinization. (???)
DDx:
- Neuroendocrine tumour.
Lymphoepithelial (squamous cell) carcinoma
See also
References
- ↑ 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.
- ↑ 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.
- ↑ URL: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970297-2. Accessed on: March 9, 2010.
- ↑ URL: http://www.biomedcentral.com/1471-2407/6/146. Accessed on: March 9, 2010.