Difference between revisions of "An introduction to head and neck pathology"

Jump to navigation Jump to search

An introduction to head and neck pathology (view source)

Revision as of 15:00, 25 February 2014

2,930 bytes removed ,  15:00, 25 February 2014
→‎Squamous cell carcinoma of the head and neck: split out
Line 491: Line 491:


==Squamous cell carcinoma of the head and neck==
==Squamous cell carcinoma of the head and neck==
{{Main|Squamous cell carcinoma}}
{{Main|Squamous cell carcinoma of the head and neck}}
===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====
*Rare.
*+/-EBV.


==Small cell anaplastic carcinoma==
==Small cell anaplastic carcinoma==
Michael
48,836

edits

Retrieved from "https://librepathology.org/wiki/Special:MobileDiff/29855"

Navigation menu