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Head and Neck Pathology

Jeffrey A Elo, Ho-Hyun Sun, Joel M Laudenbach, Hardev M Singh
A case of Cowden syndrome (CS) is described in a 34-year-old African American female who reported a history of breast and thyroid malignancies. Clinical examination demonstrated multiple soft, white-pink papules across multiple mucosal surfaces of the oral cavity. Microscopy of the lesions revealed hyperkeratotic surface squamous epithelium with papillomatosis and acanthosis along with elongated rete processes. A genomic polymerase chain reaction direct sequencing using the patient's blood was positive for mutations of the PTEN gene typical of CS...
January 10, 2017: Head and Neck Pathology
Astrid De Meulenaere, Tijl Vermassen, Sandrine Aspeslagh, Katrien Vandecasteele, Sylvie Rottey, Liesbeth Ferdinande
The assessment of tumor infiltrating lymphocytes (TILs) has recently emerged as a prognostic biomarker in several solid tumors. Quantification and subtyping of TILs reflects the immune response in the tumor microenvironment, contributing to either tumoral immune attack or escape and thereby affecting outcome. Despite the growing evidence of its value as prognosticator, TILs analysis has not yet found its way to daily clinical practice. The aim of this review is to evaluate whether the current knowledge on TILs in head and neck cancer justifies its clinical implementation...
December 28, 2016: Head and Neck Pathology
Mark Kubik, Nicholas Barasch, Garret Choby, Raja Seethala, Carl Snyderman
The differential diagnosis for clear cell neoplasms of the sinonasal tract is wide but critical to understand. In this paper, we describe a case of renal cell-like adenocarcinoma (SNRCLA) presenting as a paranasal sinus mass with clear cell morphology. The relevant literature is reviewed and the workup for clear cell neoplasms described. SNRCLA is a rarely encountered low grade glandular malignancy of the paranasal sinuses. Despite its morphologic mimicry of renal cell carcinoma, SNRCLA demonstrates a seromucinous phenotype and is associated with a favorable prognosis and low recurrence rates after surgical resection...
December 28, 2016: Head and Neck Pathology
Jonathan Chatzkel, James S Lewis, Jessica C Ley, Tanya M Wildes, Wade Thorstad, Hiram Gay, Mackenzie Daly, Ryan Jackson, Jason Rich, Randal Paniello, Brian Nussenbaum, Jingxia Liu, Barry A Siegel, Farrokh Dehdashti, Douglas Adkins
Determine if highly proliferative head and neck squamous cell carcinomas, assessed by pretreatment Ki-67 expression, respond more robustly to induction chemotherapy (IC) that is selectively toxic to cycling cells. Retrospective analysis of 59 patients treated with IC and chemoradiation. IC included either nab-paclitaxel, cisplatin, 5-FU and cetuximab (APF-C, n = 27) or docetaxel, cisplatin, 5-FU +/- cetuximab (TPF+/-C, n = 32). Ki-67 expression was assessed by immunohistochemistry. Tumor response (complete/partial/stable/progressive) at the primary site after two IC cycles was evaluated by visual examination in all patients...
December 26, 2016: Head and Neck Pathology
Rajiv S Desai, Saurabh Nagar, Raguram Ganesan, Shivani Bansal, Pankaj M Shirsat
Tubulopapillary hidradenoma is an uncommon benign sweat gland tumour which appears as a well-defined superficially located dermal nodule, most commonly occurring in the head or of the extremities. Its occurrence is extremely rare in the mandible, as there are only two cases of tubulopapillary hidradenoma-like tumour of the mandiblereported in the literature. Microscopically, the lesion appears as a well circumscribed but unencapsulated neoplasm composed of numerous irregularly shaped tubular structures that have a double to several layered epithelial lining...
December 9, 2016: Head and Neck Pathology
Eleanor Chen, Robert Ricciotti, Neal Futran, Dolphine Oda
Head and neck rhabdomyosarcoma occurs frequently in children and adolescents, and has been well studied in that population. In contrast, it is rare in adults and is not as well characterized clinically and pathologically. Seven cases of adult rhabdomyosarcoma occurring in head and neck were retrieved from the archives of Department of Pathology and Division of Oral Pathology at University of Washington. Radiologic findings and clinical history, as well as pathologic findings from hematoxylin and eosin slides and immunohistochemistry for myogenic markers were reviewed...
November 28, 2016: Head and Neck Pathology
Yeshwant B Rawal, Kenneth M Anderson, Thomas B Dodson
The pseudomyogenic hemangioendothelioma (PMH) is a low-grade malignant vascular neoplasm of different tissue planes including skin and soft tissue. Primary tumors in the skeletal muscle and bone have also been diagnosed. The PMH was introduced into the WHO classification of tumors of soft tissue and bone in 2013. This is the first description of oral involvement. A 21-year-old female presented with a 2-month old swelling of her gingiva. The swelling appeared red in color and was soft in consistency. A clinical diagnosis of a pyogenic granuloma was made and an incisional biopsy was submitted for histopathological evaluation...
November 22, 2016: Head and Neck Pathology
Dikson Dibe Gondim, Rebecca Chernock, Samir El-Mofty, James S Lewis
Distant metastases are relatively common in breast cancer, but spread to the head and neck region is uncommon and can be diagnostically challenging. Pathology databases of two academic hospitals were searched for patients. The diagnoses were by morphologic comparison with the primary breast specimen (when available) or through the use of immunohistochemical stains characteristic of breast carcinoma (cytokeratin 7, mammaglobin, GCDFP15, and/or GATA3 positive-excluding new primary tumors at the respective head and neck sites)...
November 14, 2016: Head and Neck Pathology
Julia Thierauf, Johannes A Veit, Jochen K Lennerz, Stephanie E Weissinger, Annette Affolter, Johannes Döscher, Christoph Bergmann, Andreas Knopf, Jennifer Grünow, Lisa Grünmüller, Cornelia Mauch, Peter K Plinkert, Thomas K Hoffmann, Jochen Hess
Mucosal melanomas of the head and neck (MMHN) are aggressive tumors with poor prognosis, different opposed to cutaneous melanoma. In this study, we characterized primary mucosal malignant melanoma for the expression of Kallikrein-related peptidase 6 (KLK6), a member of the KLK family with relevance to the malignant phenotype in various cancer types including cutaneous melanoma. Paraffin-embedded MMHN of 22 patients were stained immunohistochemically for KLK6 and results were correlated with clinical and pathological data...
November 14, 2016: Head and Neck Pathology
Ana Cláudia Garcia Rosa, Andresa Borges Soares, Cristiane Furuse, Sandro Régis Rodrigues Lima, Vera Cavalcanti de Araújo, Fabricio Passador-Santos
Adenomatoid odontogenic tumor (AOT) is a benign epithelial odontogenic tumor characterized by slow and progressive growth. When central lesions are associated with an unerupted permanent tooth, they are also known as the follicular type. Histological variants of AOT may complicate diagnosis with possible adverse effects on treatment and prognosis. The aim of this study is to report a case of a follicular AOT with extensive calcifying epithelial odontogenic tumor (CEOT)-like histopathological areas in the anterior region of the mandible that was treated by enucleation...
November 5, 2016: Head and Neck Pathology
Helvécio Marangon Júnior, Paulo Eduardo Alencar Souza, Rodrigo Villamarim Soares, Ricardo Santiago Gomez, Gustavo Henrique de Mattos Pereira, Martinho Campolina Rebello Horta
Lichen sclerosus (LS) is a chronic inflammatory mucocutaneous disease that often affects the anogenital area and causes significant discomfort and morbidity. Oral mucosal lesions in LS are extremely rare and might be associated with genital and/or skin manifestations. As a unique manifestation of LS, oral lesions are even more rare, with only 20 cases reported in English-language literature. In reviewing that literature in this paper, we present the case of a 44-year-old white man who sought dental assistance with a complaint of a white spot on his upper lip...
November 2, 2016: Head and Neck Pathology
Ann Margaret V Chang, Simion I Chiosea, Alexey Altman, Hester A Pagdanganan, Changqing Ma
Most nasopharyngeal carcinomas (NPCs) in a high-incidence population are driven by Epstein-Barr virus (EBV) infection. EBV-associated malignancies have increased expression of the programmed death-ligand 1 (PD-L1). Immunotherapy agents targeting the PD-1/PD-L1 pathway have achieved durable treatment effects in patients with various cancer types including EBV-associated malignancies. In this study, we sought to investigate PD-L1 expression in a cohort of patients with NPCs from the Philippines. Fifty-six NPCs were studied for PD-L1, p16, and DNA mismatch repair (MMR) deficiency by immunohistochemistry...
November 2, 2016: Head and Neck Pathology
Rhona Sproat, Gentle Wong, John Rubin
A 55-year-old lady with a 6 month history of hoarse voice presented to our ENT department. Endoscopic examination displayed a white left arytenoid lesion. Biopsy of this lesion displayed a nodule covered with non-keratinizing stratified squamous epithelium, with a central core of polygonal cells, positive for S-100 staining. This confirmed a granular cell tumour. CO2 laser was utilised to excise this benign tumour. Granular cell tumours of the head and neck are common, but are infrequently found in the larynx...
December 2016: Head and Neck Pathology
Liyan Xu, Elza Matrova, Nicholas Edward Dietz
Mycobacterium avium complex (MAC) is primarily a pulmonary pathogen that affects individuals who are immune deficient or immunocompromised. In this report, we describe a very rare case of MAC infection clinically presenting as a nasal polyp in a patient with type 2 diabetes mellitus. This case illustrates an atypical anatomic location for MAC, the anterior nasal septum in nasal cavity, as well as often overlooked cause of immune compromise, diabetes mellitus. We present the laboratory findings that lead to the diagnosis as well as a brief review of MAC infections...
December 2016: Head and Neck Pathology
Emily A Lanzel, Ali Pourian, Saulo L Sousa Melo, Kim A Brogden, John W Hellstein
The aim of this study was to compare the immunoexpression of epithelial mucins (MUCs) in salivary duct cysts, papillary cystadenomas, and mucoepidermoid carcinomas and to evaluate if any of these markers could be useful for differentiating between mucoepidermoid carcinoma and papillary cystadenoma. We also sought to validate the p63 expression pattern found to differentiate between mucoepidermoid carcinoma and papillary cystadenoma. Immunoexpression of MUC1, MUC2, MUC4, MUC7, and p63 was studied and quantified in 22 mucoepidermoid carcinomas, 12 papillary cystadenomas, and 3 salivary duct cysts...
December 2016: Head and Neck Pathology
Tatyana Milman, Gui-Shuang Ying, Wei Pan, Virginia LiVolsi
Ameloblastoma is a rare, locally aggressive odontogenic neoplasm, accounting for fewer than 1 % of head and neck tumors. Recent literature suggests that the initial surgical approach and histologic growth patterns are the most important prognostic determinants in ameloblastoma. The aim of this study was to compare the clinical presentation, management, and outcomes of patients with ameloblastoma with data reported in the literature; the study spanned 2 decades at a single institution. The institution's database was searched for all patients with pathologically confirmed ameloblastoma, diagnosed between 1990 and 2015...
December 2016: Head and Neck Pathology
Tatiana Fernandes Araujo Almeida, Esmeralda Maria da Silveira, Cássio Roberto Rocha Dos Santos, Jorge Esquiche León, Ana Terezinha Marques Mesquita
A case of oral leishmaniasis without cutaneous involvement affecting the upper alveolar ridge mucosa/gingiva and the hard palate is reported in a 41-year-old Brazilian man. Microscopic examination disclosed scarce amastigotes and the definitive diagnosis was facilitated by immunohistochemical analysis. The clinical presentation of this lesion is unusual and underlies the importance of considering leishmaniasis in the differential diagnosis of oral lesions, especially in endemic areas. A literature review of the cases of mucosal leishmaniasis with exclusive primary lesions of the oral mucosa was also performed...
December 2016: Head and Neck Pathology
M Cunnane, L Cheung, A Moore, S di Palma, A McCombe, L Pitkin
We conclude that patients presenting with level 5 lymphadenopathy should be investigated with heightened clinical vigilance. Our results suggest that up to 80 % will harbour clinically significant pathology requiring further medical treatment, three quarters of which will be malignancy. We report an observational study of histological outcomes of level 5 lymph node biopsies from a regional histopathology department across 5 years. 184 subjects were identified as having a biopsy of a lymph node from the level 5 region within the study period...
December 2016: Head and Neck Pathology
Anne M Mills, Maria Luisa C Policarpio-Nicholas, Abbas Agaimy, Mark R Wick, Stacey E Mills
Microcystic adnexal carcinoma (MAC) occurs predominantly in the centrofacial skin and has been only rarely reported in mucosal surfaces. We here present a 5 case series of tumors closely resembling MAC occurring in the mucosal surfaces of the head and neck, which we have termed sclerosing microcystic adenocarcinomas. These tumors showed a predilection for women (4:1) with an average patient age of 52.6 years (range 41-73 years). Location included the tongue (n = 2), the floor of the mouth (n = 2), and the nasopharynx/clivus (n = 1)...
December 2016: Head and Neck Pathology
Thomas C Wilson, Deqin Ma, Anup Tilak, Brennan Tesdahl, Robert A Robinson
Basal cell adenoma and basal cell adenocarcinoma represent basaloid salivary gland neoplasms that show cyto-morphologic similarity but differ at the histologic level by their invasive qualities, as adenocarcinomas show invasion beyond their capsule, a finding not seen in the adenomas. Due to the low incidence of these tumors, the molecular mechanism underlying their pathogenesis is poorly understood. We sought to further delineate these neoplasms through mutation profiling by targeted next-generation sequencing (NGS)...
December 2016: Head and Neck Pathology
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