48,830
edits
Difference between revisions of "Squamous cell carcinoma of the head and neck"
Jump to navigation
Jump to search
Squamous cell carcinoma of the head and neck (view source)
Revision as of 15:00, 25 February 2014
, 15:00, 25 February 2014split out
(redirect) |
(split out) |
||
| Line 1: | Line 1: | ||
'''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]] | |||