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Head and Neck Pathology

Helvécio Marangon Junior, Victória Vasconcellos Moreira Melo, Ângela Braga Caixeta, Giovanna Ribeiro Souto, Paulo Eduardo Alencar Souza, Maria Cássia Ferreira de Aguiar, Martinho Campolina Rebello Horta
Tumor budding is a prognostic marker for oral squamous cell carcinoma (OSCC) characterized by the presence of isolated or small clusters of neoplastic cells at the tumor invasive front. Aldehyde dehydrogenase-1 (ALDH1) is associated with tumorigenesis, linked to treatment resistance and shown to identify cancer stem cells (CSC)-like cells. This study aimed to evaluate the expression of ALDH1 and its association with tumor budding in OSCC. Immunohistochemistry was employed in 163 OSCC samples to identify pancytokeratin (AE1/AE3) and ALDH1...
November 14, 2018: Head and Neck Pathology
Li Liang, Michelle D Williams, Diana Bell
Salivary duct carcinoma (SDC) is an aggressive neoplasm that resembles high-grade invasive ductal carcinoma of the breast. It can develop de novo or from the malignant transformation of pleomorphic adenoma (PA). We performed immunohistochemical stains for phosphatase and tensin homologue [PTEN androgen receptor (AR)], HER2/neu, cytokeratin 5/6, estrogen receptor-beta, high-mobility group AT-hook 2 (HMGA2), and pleomorphic adenoma gene 1 (PLAG1) on tissue microarray samples of 75 SDCs and 31 adenocarcinomas, not otherwise specified (NOS)...
November 2, 2018: Head and Neck Pathology
Teresa Cox, Jamie Woodhead, Brenda L Nelson
Reticular oral lichen planus is a common clinical finding, often found incidentally on routine oral examination. Patients rarely complain of symptoms and the condition does not require treatment, as a result, biopsies and ancillary laboratory evaluation are seldom performed. We present a case of reticular oral lichen planus with a classic clinical presentation and characteristic histologic findings.
November 2, 2018: Head and Neck Pathology
Rekha Reddy, Sarah G Fitzpatrick, Indraneel Bhattacharyya, Donald M Cohen, Mohammed N Islam
Chronic ulcerative stomatitis (CUS) is a poorly understood disease with clinical and histologic overlap with lichen planus (LP). Unlike classic LP, direct immunofluorescence (DIF) studies in cases of CUS exhibit a granular pattern of IgG in nuclei of basal and parabasal cells. This study assesses the demographic, clinical, histologic, and DIF features of CUS. It is important to differentiate CUS from LP and other vesiculobullous diseases (VBD) because lesions of CUS are resistant to steroid therapy, which is typically used to control LP and VBD...
October 29, 2018: Head and Neck Pathology
Fredrik Petersson
A case of sclerosing polycystic adenosis without cysts is described. The lesion occurred as a painless slow growing superficial right parotid lump in a 47 years old woman. The tumor measured 14 × 10 mm and displayed extreme well circumscription, sclerotic stroma with scattered hyaline nodules, sprinkling of mononuclear inflammatory cells and islands of mature fat. The epithelial component was predominantly composed of tubules lined by low columnar to cuboidal epithelium with bland nuclear features. Only focal incomplete acinar differentiation with few cells containing small eosinophilic granules was present...
October 25, 2018: Head and Neck Pathology
Kevin C Lee, Sung-Kiang Chuang, Elizabeth M Philipone, Scott M Peters
Head and neck angiosarcomas (HN-AS) are rare malignancies with a poor prognosis relative to other soft tissue sarcomas. To date, the HN-AS literature has been limited to short reports and single-institution experiences. This study evaluated patients registered with the Surveillance, Epidemiology, and End Results (SEER) program who had been diagnosed with a primary HN-AS. Predictors were drawn from demographic and baseline tumor characteristics. Outcomes were survival months and cause of death. Kaplan-Meier analyses were used to estimate overall (OS) and disease-specific survival (DSS) rates...
October 24, 2018: Head and Neck Pathology
Pooja Navale, Eric M Genden, Mary Beth Beasley
Oropharyngeal squamous cell carcinomas associated with high risk HPV show a wide morphological spectrum, including papillary, adenosquamous, lymphoepithelioma-like and sarcomatoid. We report an interesting case of ciliated HPV-related carcinoma arising from tonsillar tissue in a 55-year-old man which was associated with HPV33. This rare variant has been described in only a handful of cases in the literature, and to our knowledge this is the first case specifically associated with HPV33. The presence of cilia is a potential diagnostic problem as it has been traditionally considered a feature of benignancy, and could pose a particular challenge on frozen section...
October 17, 2018: Head and Neck Pathology
Emilija Todorovic, Eric Berthelet, Robert O'Connor, J Scott Durham, Eric Tran, Monty Martin, Malcolm M Hayes, Tony L Ng
Sclerosing odontogenic carcinoma is a rare locally destructive neoplasm with many histologic mimics. Here the diagnostic challenges are presented of a case of sclerosing odontogenic carcinoma with variable histologic features, including unusual and unexpected negative immunostaining for CK19.
October 12, 2018: Head and Neck Pathology
Marianne Abouyared, Darcy A Kerr, Brandon Burroway, Joseph Sabra, Zoukaa Sargi, Elizabeth Nicolli, Jason Leibowitz
Pharyngocutaneous fistula after laryngectomy is common and significantly increases the morbidity of the procedure. Intraoperative, objective variables that can reliably predict fistula formation would be useful to surgeons deciding how to reconstruct the laryngectomy defect. Retrospective chart review of 50 radiated patients and 10 non-radiated patients who underwent total laryngectomy at a single tertiary care institution. Patients with pharyngocutaneous fistula were selected to ensure a representative sample were available for comparison...
October 8, 2018: Head and Neck Pathology
Lester D R Thompson, Kelly R Magliocca, Simon Andreasen, Katlin Kiss, Lisa Rooper, Edward Stelow, Bruce M Wenig, Justin A Bishop
Endolymphatic sac tumors (ELSTs) are rare, slowly growing temporal bone neoplasms which show a high association with von Hippel-Lindau (VHL) syndrome. The immunohistochemistry evaluation of these papillary-cystic neoplasms frequently raises the differential diagnosis with renal cell carcinoma, among other metastatic neoplasms, whether in VHL patients or not. A cohort of 26 patients with ELSTs were evaluated for histologic features, immunohistochemistry findings, and association with VHL. Standard immunohistochemistry evaluation was performed...
October 5, 2018: Head and Neck Pathology
Fumio Ide, Naoyuki Matsumoto, Yuji Miyazaki, Kentaro Kikuchi, Kaoru Kusama
No abstract text is available yet for this article.
October 3, 2018: Head and Neck Pathology
Veronica Balatti, Steve Oghumu, Arianna Bottoni, Kati Maharry, Luciano Cascione, Paolo Fadda, Anil Parwani, Carlo Croce, O Hans Iwenofu
Salivary duct carcinomas (SDC) and Her2/Neu3-overexpressing invasive breast carcinomas (HNPIBC/IBC) are histologically indistinguishable. We investigated whether common histopathologic and immunophenotypic features of SDC and IBC are mirrored by a similar microRNA (miRNA) profile. MiRNA profiling of 5 SDCs, 6 IBCs Her2/Neu3+, and 5 high-grade ductal breast carcinoma in situ (DCIS) was performed by NanoString platform. Selected miRNAs and HOXA1 gene were validated by RT-PCR. We observed similar miRNA expression profiles between IBC and SDC with the exception of 2 miRNAs, miR-10a and miR-142-3p, which were higher in IBC tumors...
September 26, 2018: Head and Neck Pathology
Shraddha A Adamane, Neha Mittal, Tanuja Teni, Sagar Pawar, Rohit Waghole, Munita Bal
Human papillomavirus (HPV)-related multiphenotypic sinonasal carcinoma (HMSC) is a recently described distinctive clinicopathologic entity defined by association to high risk HPV, localization to sinonasal tract and close histologic resemblance to salivary gland tumors. Lack of awareness of its pathologic features and biology among pathologists and oncologists make this entity susceptible to misdiagnosis and erroneous management. Herein, we illustrate a case of HMSC of the nasal cavity associated with heretofore unreported subtype HPV-52 and discuss the challenges associated with diagnosis and management of this rare tumor...
September 26, 2018: Head and Neck Pathology
Vikram Singh, Kirti Gupta, Pravin Salunke, Sivashanmugam S Dhandapani
Null cell adenoma is composed of adenohypophyseal cells that show no evidence of any specific cell type differentiation by immunohistochemistry or transcription factors like pituitary-specific positive transcription factor 1 and steroidogenic factor 1. Though rare, pituitary ependymoma and germinoma are also known to occur at sellar region and in such instances, it is challenging to differentiate them from a pituitary null cell adenoma featuring papillary architecture and perivascular pseudo-rosettes. We describe a case of an elderly diabetic lady presenting with headache and blurring of vision for past 3 months due to a sellar tumour...
September 24, 2018: Head and Neck Pathology
Radhika Agarwal, Latika Gupta, Meeta Singh, Nallacheruvu Yashaswini, Ashima Saxena, Nita Khurana, Dimple Chaudhary
Tuberculosis usually involves the lungs, but can also involve various other organs. Extra pulmonary tuberculosis is very rarely confined to the larynx in the absence of an associated pulmonary lesion. In this retrospective study, clinicopathological characteristics of patients with final diagnosis of laryngeal tuberculosis (LTB) were reviewed. The diagnosis of LTB was based on: (1) the existence of chronic granulomatous inflammation with caseous necrosis in the histopathology of laryngeal lesions or (2) the presence of laryngeal lesions with atypical histopathology (chronic granulomatous inflammation) which had a complete response to anti-tuberculosis therapy...
September 24, 2018: Head and Neck Pathology
Shayan Sadeghi, Maxime Azaïs, Julien Ghannoum
Cervicofacial actinomycosis is a common form of Actinomyces infection. However, the latter seldom occurs in the tongue. We present a case of a 66 year-old man with macroglossia caused by actinomycosis of the tongue. Radiographic features were compatible with a chronic inflammatory disease. Biopsies revealed granulomas containing giant cells and Gram positive bacterial clusters consistent with actinomycosis. The patient was treated with a 22 week course of antibiotics. Imaging showed a notable improvement in the extent of the lesions 1 year later...
September 22, 2018: Head and Neck Pathology
Fumio Ide, Naoyuki Matsumoto, Kentaro Kikuchi, Kaoru Kusama
No abstract text is available yet for this article.
September 21, 2018: Head and Neck Pathology
Henry Crist, Max Hennessy, Jacob Hodos, Johnathan McGinn, Bartholomew White, Sakeena Payne, Joshua I Warrick
Acute invasive fungal rhinosinusitis (AIFRS) is a fulminant infection in immunocompromised patients requiring rapid diagnosis (DX), frequently made on frozen section (FS) of sinonasal biopsies, followed by prompt surgical debridement. However, FS interpretation is often difficult and DX sometimes not possible. In this study we sought to characterize reasons for misinterpretation and methods to improve diagnostic accuracy. The FS slides from 271 biopsies of suspected AIFRS in a 16-year period were reviewed and the morphologic features evaluated for their utility in DX...
September 12, 2018: Head and Neck Pathology
Michihisa Kono, Nobuyuki Bandoh, Ryosuke Matsuoka, Takashi Goto, Toshiaki Akahane, Yasutaka Kato, Hiroshi Nakano, Tomomi Yamaguchi, Yasuaki Harabuchi, Hiroshi Nishihara
Glomangiopericytoma (GPC) is a rare mesenchymal tumor arising from the nasal cavity or paranasal sinuses. GPC was categorized as a borderline and low-malignant-potential tumor by the World Health Organization in 2005 and accounts for less than 0.5% of all sinonasal tumors. We report a case of GPC in a 74-year-old woman with a history of recurrent epistaxis and nasal obstruction. A reddish tumor was seen in the right nasal cavity. Enhanced computed tomography showed a mass lesion occupying the right nasal cavity...
September 11, 2018: Head and Neck Pathology
Zhenjian Cai, Mei Lin, Angel I Blanco, Jing Liu, Hui Zhu
Epstein-Barr Virus (EBV)-positive neuroendocrine carcinoma (NEC) of the nasopharynx is exceedingly rare, only two cases have been reported in the literature. While EBV infection is strongly associated with nasopharyngeal carcinoma, which is carcinoma with squamous differentiation, the link between EBV and NEC is not well known, and can be diagnostically challenging. In this study, we report the third case of EBV-positive large cell NEC of nasopharynx with neck lymph node metastasis. The patient was treated with combined radiation and chemotherapy and showed complete clinical and radiological response...
September 6, 2018: Head and Neck Pathology
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