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

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An introduction to head and neck pathology (view source)

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→‎Human papillomavirus-associated head and neck squamous cell carcinoma: split out
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==Human papillomavirus-associated head and neck squamous cell carcinoma==
==Human papillomavirus-associated head and neck squamous cell carcinoma==
*Abbreviated ''HPV-HNSCC''.
*Abbreviated ''HPV-HNSCC''.
===General===
{{Main|Human papillomavirus-associated head and neck squamous cell carcinoma}}
*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>
***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>
*Lesions more radiosensitive and usually have a better prognosis.<ref name=pmid22001331/>
 
===Gross===
Classic locations:
*Tonsil and base of tongue<ref name=pmid21752613/> (palatine tonsil, lingual tonsil, oropharynx).
 
Note:
*Memory device:
**Where the tip of the [[penis]] goes when someone is ''deep throating''.
 
===Microscopic===
Features:<ref name=pmid20596971>{{Cite journal  | last1 = Chernock | first1 = RD. | last2 = El-Mofty | first2 = SK. | last3 = Thorstad | first3 = WL. | last4 = Parvin | first4 = CA. | last5 = Lewis | first5 = JS. | title = HPV-related nonkeratinizing squamous cell carcinoma of the oropharynx: utility of microscopic features in predicting patient outcome. | journal = Head Neck Pathol | volume = 3 | issue = 3 | pages = 186-94 | month = Sep | year = 2009 | doi = 10.1007/s12105-009-0126-1 | PMID = 20596971 | PMC = 2811624 | URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811624/?tool=pubmed }}</ref>
*Typically non-keratinizing squamous cell carcinoma.
 
DDx:
*HPV-negative squamous cell carcinoma - see ''[[squamous cell carcinoma of the head and neck]]''.
*[[Nasopharyngeal carcinoma]].
 
Images:
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811624/figure/Fig1/ HPV NK SCC (nih.gov)].
 
===IHC===
*p16 +ve.<ref name=pmid21752613>{{Cite journal  | last1 = Heath | first1 = S. | last2 = Willis | first2 = V. | last3 = Allan | first3 = K. | last4 = Purdie | first4 = K. | last5 = Harwood | first5 = C. | last6 = Shields | first6 = P. | last7 = Simcock | first7 = R. | last8 = Williams | first8 = T. | last9 = Gilbert | first9 = DC. | title = Clinically significant human papilloma virus in squamous cell carcinoma of the head and neck in UK practice. | journal = Clin Oncol (R Coll Radiol) | volume = 24 | issue = 1 | pages = e18-23 | month = Feb | year = 2012 | doi = 10.1016/j.clon.2011.05.007 | PMID = 21752613 }}</ref>
*EBER -ve.


==Sinonasal undifferentiated carcinoma==
==Sinonasal undifferentiated carcinoma==
Michael
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