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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
Gregory B Lesinski, Sreenivas Nannapaneni, Christopher C Griffith, Mihir Patel, Wanqi Chen, Zhengjia Chen, Rafi Ahmed, Andreas Wieland, Dong M Shin, Zhuo G Chen, Nabil F Saba
This study addresses the hypothesis that IL-6/STAT3 signaling is of clinical relevance in oropharyngeal squamous cell carcinoma (OPSCC). We evaluated relationships between key components of this pathway in tumors from a unique cohort of n = 59 fully annotated, treatment-naïve patients with OPSCC. The multiplex Opal platform was utilized for immunofluorescence (IF) analysis of tissues to detect IL-6 and phosphorylated STAT3 (pSTAT3), taking into consideration its nuclear versus cytoplasmic localization...
September 6, 2018: Head and Neck Pathology
Juan C Hernandez-Prera
The 2017 World Health Organization Classification of Head and Neck Tumors introduced for the first time the diagnostic terminology "cribriform variant of polymorphous adenocarcinoma". This nomenclature attempts to reconciliate the ongoing taxonomical controversy related to cribriform adenocarcinoma of tongue. In order to better understand this classification conundrum, it is imperative for pathologist to comprehend the historical evolution of polymorphous adenocarcinoma formerly known as polymorphous "low grade" adenocarcinoma...
September 5, 2018: Head and Neck Pathology
Matthew D Morrison, Linda Jackson-Boeters, Zia A Khan, Michael S Shimizu, Jason H Franklin, Kevin Fung, John H J Yoo, Mark R Darling
Pleomorphic adenoma (PA) is the most common benign salivary gland tumor. Kallikrein-related peptidases have been identified as biomarkers in many human tumors and may influence tumor behavior. We investigated KLK1-15 messenger ribonucleic acid and proteins in PA specimens to determine a KLK expression profile for this tumor. Fresh frozen PA tissue specimens (n = 26) and matched controls were subjected to quantitative real-time reverse transcription polymerase chain reaction to detect KLK1-15 mRNA. Expression of KLK1, KLK12, KLK13, and KLK8 proteins were then evaluated via immunostaining techniques...
August 17, 2018: Head and Neck Pathology
Ciro Dantas Soares, Roman Carlos, Juan Pablo Díaz Molina, Thayná Melo de Lima Morais, Oslei Paes de Almeida
Smooth muscle tumors associated with Epstein-Barr virus infections (EBV-SMT) of laryngeal origin are exceedingly rare and have been reported in few adult patients, but not in children. This reported case describes a lesion found in the larynx of an 8-year-old Guatemalan undernourished girl. Microscopically, the lesion showed a highly cellular mesenchymal spindle cell tumor, containing frequent lymphocytes. The immunohistochemical analysis revealed positivity for α-smooth muscle actin and h-caldesmon. In addition, most of the tumor cells were positive for EBV by in situ hybridization...
August 17, 2018: Head and Neck Pathology
Neetha Santosh, Kristin K McNamara, John R Kalmar, O Hans Iwenofu
Calcifying epithelial odontogenic tumor (CEOT) is an uncommon locally invasive epithelial odontogenic tumor of the jaws associated with amyloid production. Intraosseous presentations are most common and they frequently occur in the posterior mandible. A non-calcifying Langerhans cell-rich variant of CEOT (NCLC CEOT) has been described with predilection for the anterior maxilla. Interestingly, all reported cases of NCLC CEOT have occurred in Asian population. We present a case of a 43-year old Caucasian female with a large radiolucent lesion involving the left anterior maxilla with histologic features of NCLC CEOT...
August 14, 2018: Head and Neck Pathology
John Lennon Silva Cunha, Francisco De Assis Almeida Lima-Júnior, Wilson Déda Gonçalves Júnior, Thiago De Santana Santos, Ericka Janine Dantas Da Silveira, Silvia Ferreira De Sousa, Ricardo Luiz Cavalcanti De Albuquerque-Júnior
Rhabdomyosarcoma (RMS) is a rare oral malignant soft tissue tumor whose pathological features may influence the clinical behavior, treatment and prognosis of the lesion. We report a case of a 13-year-old female patient, presenting an asymptomatic polypoid swelling in the left buccal mucosa that was approximately 2.5 cm in diameter and 3 months evolution. The presumptive diagnosis was fibrous hyperplasia and an excisional biopsy was carried out. Pathologic analysis revealed proliferation of predominantly ovoid cells, with eosinophilic cytoplasm and pleomorphic nuclei, arranged in subepithelial cambium layer...
August 9, 2018: Head and Neck Pathology
Phillip D McMullen, Julia A Bridge, Elizabeth A Blair, Carina W Yang, John Collins, Nicole A Cipriani
Aneurysmal bone cysts (ABCs) are benign lesions which most frequently occur in the long bones of pediatric patients. Long thought to be reactive, recent molecular advances have demonstrated that the majority of primary ABCs harbor rearrangements of the USP6 gene, confirming their neoplastic nature. Secondary ABCs arising from other lesions do not demonstrate this recurrent genetic anomaly. ABCs rarely occur in the craniofacial bones, and sinonasal ABCs are exceedingly rare. We report a case of a primary ABC arising the maxillary sinus of a 14-year-old female, which was found to harbor USP6 rearrangement...
August 3, 2018: Head and Neck Pathology
Rob Vogels, Daniel Baumhoer, Joost van Gorp, Astrid Eijkelenboom, Marian Verdijk, Patricia van Cleef, Elisabeth Bloemena, Pieter J Slootweg, Bjorn Lohman, Maria Debiec-Rychter, Uta Flucke
Clear cell odontogenic carcinoma (CCOC) is a rare, low-grade malignant epithelial neoplasm, occurring in the jawbones, mainly affecting the mandible of elderly patients. In addition to hyalinizing clear cell carcinoma of the salivary gland, it is one of the epithelial neoplasms known to harbor an EWSR1-ATF1 fusion. Therefore, a link between these tumors seems plausible. We describe six cases of CCOC showing EWSR1 rearrangements, with two cases being positive for the ATF1 partner gene using FISH analysis. In one case, an EWSR1-CREB1 fusion was identified using RT-PCR, which we report for the first time in this tumor type...
July 25, 2018: Head and Neck Pathology
Daniel T Ginat, Timothy Carll, Fuad M Baroody
Heterotopic gastrointestinal cyst of the oral cavity is a rare congenital lesion that may arise from ectopic undifferentiated endodermal cells. Imaging, particularly MRI, is useful for surgical planning. On MRI, the cysts typically demonstrate high signal on T2-weighted sequences and variable signal on T1-weighted sequences, which can resemble other conditions, such as dermoids. On histology, the appearance of these lesions can be variable, and may include stratified squamous, simple and ciliated columnar, as well as foveolar and intestinal-type epithelia, often surrounding by smooth muscle...
July 25, 2018: Head and Neck Pathology
Gwyneth S T Soon, Fredrik Petersson, Mark K T Thong, Char Loo Tan
A 38-year-old, previously healthy man presented with blood-stained saliva and epistaxis. A 3 mm nasopharyngeal lesion was found. A biopsy was performed and microscopic examination revealed a Kaposi sarcoma. The patient was subsequently found to be positive for human immunodeficiency virus (HIV). The diagnosis of Kaposi sarcoma in the presence of HIV infection advanced his disease to Acquired Immunodeficiency Syndrome (AIDS). Primary manifestation of Kaposi sarcoma in the nasopharynx is extremely rare. The histologic differential diagnosis of Kaposi sarcoma in this unusual site, especially without the clinical history of immunosuppression, is broad...
July 23, 2018: Head and Neck Pathology
Akeesha A Shah, Bahram Robert Oliai, Justin A Bishop
Human papillomavirus (HPV)-related multiphenotypic sinonasal carcinoma (HMSC) is a distinct, newly-described sinonasal tract neoplasm characterized by a salivary gland tumor-like appearance with myoepithelial and ductal cells, frequent surface squamous dysplasia, and relatively indolent behavior. When considering a diagnosis of HMSC, aggressive high-grade salivary gland carcinomas, particularly those with a basaloid morphology such as basal cell adenocarcinoma and adenoid cystic carcinoma, enter the differential diagnosis...
July 19, 2018: Head and Neck Pathology
Fumio Ide, Naoyuki Matsumoto, Kentaro Kikuchi, Kaoru Kusama
No abstract text is available yet for this article.
July 19, 2018: Head and Neck Pathology
Ricardo Natã Fonseca Silva, Elismauro Francisco Mendonça, Aline Carvalho Batista, Rita de Cássia Gonçalves Alencar, Ricardo Alves Mesquita, Nadia Lago Costa
T-cell/histiocyte-rich large B-cell lymphoma (THRBCL) is an uncommon subtype of non-Hodgkin's lymphoma. It is a predominant nodal neoplasm; however, extranodal sites, such as the spleen, liver and bone marrow, can be involved at diagnosis. However, only one case of primary THRLBCL in the jaws have been reported. We herein describe a 29-year-old female patient who presented with a swelling of the right mandible that had grown rapidly over the previous 2 months. Periapical and panoramic radiographs showed a multilocular osteolytic lesion located in the mandibular periapical region of the canine and premolar teeth and molar region...
July 17, 2018: Head and Neck Pathology
Kerry B Baumann, Sasha J Betz
Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is a rare entity. Patients often present with complaints of nasal fullness, obstruction, and epistaxis. It may be confused with metastatic papillary thyroid carcinoma due to its histologic similarity and overlapping immunohistochemical studies, but it is important to distinguish between the two because of differing treatment modalities and prognosis. A significant difference between the two is that despite both entities demonstrating TTF-1 positivity, TL-LGNPPA usually does not stain for thyroglobulin...
July 11, 2018: Head and Neck Pathology
Ranran Zhang, Alain Cagaanan, Gholam-Reza Hafez, Rong Hu
Sclerosing microcystic adenocarcinoma is an exceedingly rare entity occurring in the mucosal surfaces of the head and neck that closely resembles cutaneous microcystic adnexal carcinoma. Here, we report a case of sclerosing microcystic adenocarcinoma that presented as a vague mass at the floor of the mouth in a 55-year-old woman. The pathology features and the diagnostic challenges, especially in the biopsy and margin evaluation are discussed here. Similar cases published in the English literatures are reviewed...
July 10, 2018: Head and Neck Pathology
Rehan Rais, Samir K El-Mofty
Ameloblastomas are the most common odontogenic tumors, excluding odontomas. Several morphologic variants have been described including follicular, plexiform, acanthomatous, granular cell, basaloid and desmoplastic. Desmoplastic ameloblastoma differs from other conventional ameloblastomas microscopically, clinically, and radiographically. Ameloblastic carcinoma, the malignant counterpart of ameloblastoma is characterized by cytologic features of malignancy combined within the overall histologic features of conventional ameloblastoma...
July 4, 2018: Head and Neck Pathology
Kelly R Magliocca, Michelle D Williams
No abstract text is available yet for this article.
September 2018: Head and Neck Pathology
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