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Head and Neck Pathology

Alessandro Antônio Costa Pereira, Christian Barros Ferreira, João Adolfo Costa Hanemann, Livia Maris Ribeiro Paranaiba, Patricia Peres Iucif Pereira, Carla Isabelly Rodrigues-Fernandes, Celeste Sánchez-Romero, Oslei Paes de Almeida, Felipe Paiva Fonseca
Lymphomatoid granulomatosis (LYG) is a rare B-cell lymphoproliferative disorder driven by Esptein-Barr virus (EBV) that most commonly affects the lungs, although extra pulmonary sites like the central nervous system, skin, liver and kidney can also be involved. It is microscopically characterized by an angiocentric and angiodestructive growth pattern, predominantly composed by small T-cells, although a smaller population of atypical large B-cells is considered the true neoplastic component. Oral cavity involvement of LYG has rarely been described and the diagnosis of this neoplasm is very difficult...
March 14, 2018: Head and Neck Pathology
Eugene M Ko, Jonathan B McHugh
This clinicopathologic study of primary oral leiomyosarcoma of the buccal mucosa involves a literature review of 15 cases with the addition of our report of a case. The demographic details, tumor size, treatment and outcome are documented for all the cases. In addition, this review examines the histologic features of leiomyosarcoma while noting that differentiation from other spindle cell tumors can be challenging, underscoring the necessity of an immunohistochemical work up for an accurate diagnosis. The unpredictability of the clinical behavior of these aggressive tumors requires, at the very least, wide local surgical excision and prolonged follow up...
March 13, 2018: Head and Neck Pathology
Liron Pantanowitz, Lester D R Thompson, Esther Diana Rossi
Fine needle aspiration (FNA) has diagnostic and therapeutic value in the management of salivary gland cysts. Rendering an accurate diagnosis from an aspirated salivary gland cyst is challenging because of the broad differential diagnosis, possibility of sampling error, frequent hypocellularity of specimens, morphologic heterogeneity, and overlapping cytomorphology of many cystic entities. To date, there have been no comprehensive review articles providing a practical diagnostic approach to FNA of cystic lesions of salivary glands...
March 9, 2018: Head and Neck Pathology
Vincent Cracolici, Thomas Krausz, Nicole A Cipriani
Papillary thyroid carcinoma (PTC) is defined by an invasive growth pattern and classic nuclear features: enlarged, grooved, overlapping nuclei with chromatin clearing and intranuclear cytoplasmic pseudoinclusions (INCP). True INCPs are characteristic of PTC, but may infrequently be seen in noninvasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP). Nuclear abnormalities that mimic INCP ("pseudo-pseudoinclusions") are common in a variety of thyroid lesions. H&E and ubiquitin-stained whole tissue sections of classic PTC (n = 25) and NIFTP (n = 35) were evaluated...
March 6, 2018: Head and Neck Pathology
Ioannis Siamantas, Eleni-Marina Kalogirou, Konstantinos I Tosios, Ioannis Fourmousis, Alexandra Sklavounou
Localized juvenile spongiotic gingival hyperplasia (LJSGH) is a gingival lesion with unique clinicopathologic features that may involve synchronously multiple sites. We present a case with lesions clinically consistent with LJSGH in four jaw quadrants, confirmed by biopsy and review the English literature on multifocal LJSGH cases. A 19 year-old woman presented with circumscribed, erythematous overgrowths on the right and left maxillary and mandibular gingiva. With the provisional diagnosis of multifocal LJSGH, total excision of four maxillary lesions was performed...
March 6, 2018: Head and Neck Pathology
Abbas Agaimy, Sarina K Mueller, Thomas Harrer, Sebastian Bauer, Lester D R Thompson
Kaposi sarcoma (KS) of the head and neck area is uncommon with limited published case series. Our routine and consultation files were reviewed for histologically and immunohistochemically proven KS affecting any cutaneous or mucosal head and neck site. Ten males and one female aged 42-78 years (median, 51 years; mean, 52 years) were retrieved. Eight patients were HIV-positive and three were HIV-negative. The affected sites were skin (n = 5), oral/oropharyngeal mucosa (n = 5), and lymph nodes (n = 3) in variable combination...
March 5, 2018: Head and Neck Pathology
Anik Saha, Omar Breik, Ian Simpson, Ricky Kumar
The diagnosis of osteomas in the paediatric population can pose a challenge to pathologists in excluding malignant bony tumours. We present the case of a 10-year old male presenting with a large left mandibular radiopaque lesion. This paper discusses the case of a central osteoma with osteoblastoma-like features, literature review, differential diagnosis of radiopaque lesions of the maxilla and mandible as well as a detailed discussion of the pathology of the lesion. Although similar lesions have been described in the sino-orbital region, this is believed to be the first report of this pathological entity in the mandible...
March 5, 2018: Head and Neck Pathology
Hattan Zaki, Amarpreet Sabharwal, Jill Kramer, Alfredo Aguirre
Laugier-Hunziker syndrome (LHS, also termed idiopathic lenticular mucocutaneous hyperpigmentation) is an unusual condition characterized by progressive pigmentation of the mucous membranes. LHS displays a benign course and is not associated with malignancy. Here we present a case of LHS with a 7-year follow-up. We document metachronous oral melanoacanthomas in this individual. In addition, we found that the oral melanotic macules in this patient waxed and waned in a cyclical manner. To our knowledge, this is the first report of these findings in the context of LHS...
February 15, 2018: Head and Neck Pathology
Samir El-Mofty
No abstract text is available yet for this article.
February 15, 2018: Head and Neck Pathology
Erich Raubenheimer, Claudia Noffke
No abstract text is available yet for this article.
February 14, 2018: Head and Neck Pathology
Akeesha A Shah, Eric D Lamarre, Justin A Bishop
Human papillomavirus (HPV)-related multiphenotypic sinonasal carcinoma is a peculiar sinonasal tract tumor that demonstrates features of both a surface-derived and salivary gland carcinoma. Implicit in its name, this tumor has a consistent association with high-risk HPV, particularly type 33. It was first described in 2013 under the designation of HPV-related carcinoma with adenoid cystic carcinoma-like features. However, since its initial description additional cases have emerged which demonstrate a wide morphologic spectrum and relatively indolent clinical behavior...
February 14, 2018: Head and Neck Pathology
Jasbir D Upadhyaya, Sarah G Fitzpatrick, Mohammed N Islam, Indraneel Bhattacharyya, Donald M Cohen
Proliferative verrucous leukoplakia (PVL) is defined as an aggressive, relentless and recalcitrant form of leukoplakia that has a high propensity for malignant transformation. The aim of this study was to evaluate the malignant potential of PVL and determine its possible association with high-risk human papillomavirus (HPV). Twenty cases with a clinical and biopsy proven diagnosis of PVL were collected from the University of Florida Oral Medicine clinic database. Immunohistochemistry was performed to evaluate the expression of p16INK4A and p53 genes in the PVL lesions...
February 9, 2018: Head and Neck Pathology
Shyam Prajapati, Juan C Hernandez-Prera
Subacute thyroiditis (SAT) is a self-limiting inflammatory condition of the thyroid gland in which multinucleated giant cells constitute a key histological finding. SAT is generally a clinical diagnosis and consequently its histological features are rarely encountered by pathologist. Herein, we present a case that exemplifies the characteristic clinical and pathological features of this entity. In addition, we compare SAT to other thyroid disorders characterized by the presence of multinucleated giant cells...
February 9, 2018: Head and Neck Pathology
Celeste Sánchez-Romero, Roman Carlos, Ciro Dantas Soares, Oslei Paes de Almeida
Multinucleated giant cell (MGC) reaction in oral squamous cell carcinoma (OSCC) usually represents a stromal foreign body reaction to keratin from neoplastic epithelial cells. We describe and illustrate by double immunohistochemistry a case of a tongue squamous cell carcinoma (SCC) in a 70-year-old female patient, with a copious MGC reaction not associated to keratin, showing a histopathological pattern not described before. The MGCs were directly associated with neoplastic cells, which are phagocytosed by the MGCs...
February 9, 2018: Head and Neck Pathology
Diana Bell
Sinonasal tumors with neuroendocrine differentiation form a group of rare heterogeneous neoplasms of neuroectodermal and epithelial origin, consisting of olfactory neuroblastomas and neuroendocrine carcinomas. Because the natural history and biological behavior of this group of tumors vary, the morphological diagnosis coupled with grading/staging is important for prognostication, and the approach to treatment and rehabilitation is multidisciplinary. The identification of molecular abnormalities underlying these tumors is critical to the development of specific targeted therapies and the design of clinical trials...
February 9, 2018: Head and Neck Pathology
Rekha Reddy, Liya Davidova, Indraneel Bhattacharyya, Donald M Cohen, Mohammed N Islam, Sarah G Fitzpatrick
Skin lesions are often submitted to oral and maxillofacial pathology practices. The purpose of this study is to evaluate the frequency, distribution, variability, and composition of dermatologic lesions within a large oral and maxillofacial pathology biopsy service. An IRB-approved retrospective search of skin lesions diagnosed at University of Florida oral and maxillofacial pathology biopsy service between 1994 and 2015 was performed. 2487 cases were included in the study. Gender was reported in 2466 cases, of which 59% were male and 41% female...
January 16, 2018: Head and Neck Pathology
Fumio Ide, Naoyuki Matsumoto, Kentaro Kikuchi, Kaoru Kusama
No abstract text is available yet for this article.
January 16, 2018: Head and Neck Pathology
Alexandra C Perks, Paula M Farthing, Ruth Murphy, Anne M Hegarty
Pemphigus is a chronic autoimmune condition that can affect multiple areas of the body. The two main subtypes of pemphigus are pemphigus vulgaris (PV) and pemphigus foliaceus (PF) which can rarely occur concurrently or even transition from one to the other. The process of transition may be explained by qualitative changes in desmoglein autoantibody profile. We present a rare case of concomitant PF and oral PV and explore the literature on transitions between pemphigus subtypes and whether this case could represent a transition from PF to PV...
January 16, 2018: Head and Neck Pathology
Jason K Wasserman, Sylvia Papp, Andrew J Hope, Bayardo Perez-Ordóñez
Neuroendocrine carcinomas of the head and neck are rare and are classified as well differentiated, moderately differentiated, and poorly differentiated carcinomas with the latter category being subdivided into small cell and large cell neuroendocrine carcinoma (LCNEC). While most carcinomas in the nasopharynx are associated with Epstein-Barr virus (EBV), there has been only one previous report demonstrating a link between EBV and LCNEC of the nasopharynx. In this report we describe a second case of EBV-positive LCNEC arising in the nasopharynx with bilateral cervical metastases...
January 4, 2018: Head and Neck Pathology
Jalal B Jalaly, Souzan Sanati, Rebecca D Chernock, Dikson G Dibe, Samir K El-Mofty
Salivary duct carcinoma (SDC) is a high-grade salivary gland malignancy with great morphological resemblance to invasive ductal carcinoma (IDC) of the breast. Rarely, female patients may have a past history of both SDC and IDC. When these patients present with distant metastasis, accurate identification of the primary tumor is particularly difficult. Additionally, rare metastasis of SDC to the breast and IDC to the salivary (parotid) gland can also present a diagnostic challenge. Our aim was to develop an immunohistochemical panel that reliably distinguishes SDC from IDC...
January 4, 2018: Head and Neck Pathology
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