CEOT Variants or Entities: Time for a Rethink? A Case Series with Review of the Literature
AbstractThe first detailed description of calcifying epithelial odontogenic tumor (CEOT) are ascribed to Jens Pindborg, but this tumor was described some years previously. Subsequently, CEOT was included in the 1971 WHO classification of odontogenic tumors and a since then number of variants have been described, which have added confusion to the diagnostic criteria. We aimed to survey the literature on the variants of CEOT, in parallel with a review of our single institution experience of CEOTs. Cases identified were collated, including available clinical, radiological and histological information and then reviewed, taking...
Source: Head and Neck Pathology - July 8, 2020 Category: Pathology Source Type: research

Dermal Filler Presenting as Parotid Mass: A Case Report
AbstractDermal filler injections are common cosmetic procedures and are growing in popularity. While frequently performed, dermal filler injections carry a risk of adverse events including vascular compromise and foreign body granulomas. Here, we discuss an unusual case of a patient with a history of dermal filler injections presenting with a parotid mass and an eyebrow mass requiring surgical resection. This case demonstrates the risk of delayed granuloma formation many years after dermal filler injection and highlights the importance of awareness and management of these potential long-term complications. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - July 8, 2020 Category: Pathology Source Type: research

Human Tissue Kallikreins in Polymorphous Adenocarcinoma: A Polymerase Chain Reaction and Immunohistochemical Study
AbstractPolymorphous adenocarcinoma (PAC) is the second most common malignant salivary gland tumour of minor salivary glands. Human tissue kallikreins (KLKs) are a family of highly conserved serine proteases expressed by various tissues and organs. The literature demonstrates a link between KLKs and salivary gland neoplasms. The purpose of this study was to determine levels of KLK mRNA in tissue samples of PAC and to determine if KLK expression is limited to tumour cells. Nineteen cases of PAC were reviewed (1987 –2013). The diagnosis was confirmed, demographic data was collected, and formalin fixed paraffin-embedded...
Source: Head and Neck Pathology - June 26, 2020 Category: Pathology Source Type: research

Extranodal NK/T Cell Lymphoma, Nasal Type with Palatal Involvement: A Rare Case Report and Literature Review
AbstractT-cell lymphomas are infrequently encountered in the head and neck area, with the most common subtype being Extranodal NK/T cell lymphoma, nasal type (ENKTL-NT). ENKTL-NT shows a predilection for midline facial structures presenting with ulcerative destructive lesions, whereas palatal involvement is one of the most prominent signs from the oral cavity. Herein, we describe a case of a 76-year-old Greek man with nasal obstruction and an extensive painful necrotic ulcer with ragged borders on the left distal portion of the soft palate and palatine tonsil of 4-months duration. After an initial non-diagnostic biopsy fro...
Source: Head and Neck Pathology - June 25, 2020 Category: Pathology Source Type: research

Galectin-3 Expression in High-Risk HPV-Positive and Negative Head & amp; Neck Squamous Cell Carcinomas and Regional Lymph Node Metastases
AbstractDespite higher stages at presentation, patients with high-risk (HR) HPV-related (HPV+) head and neck squamous cell carcinomas (HNSCCs) have better survival rates compared to those with non-HPV-related (HPV −) disease. However, significant comorbidity and the number of patients who suffer failed treatment, recurrent disease, late metastasis, and death are increasing along with the incidence of HPV+ HNSCC. A cytotoxic T-cell-dependent immune response is required to clear these antigenic cancers. Th is provides a unique opportunity to employ immune modulators in therapy. Galectin-3 (Gal-3) is a lecti...
Source: Head and Neck Pathology - June 20, 2020 Category: Pathology Source Type: research

Prognostic Significance of Granuloma and Amyloid Deposition in Nasopharyngeal Carcinoma
This study aimed to evaluate their clinicopathologic associations. The histopathologic findings of 747 consecutive patients with primary NPC were retrospectively reviewed between January 2001 and December 2015. The presence of granulomas and amyloid deposits was observed in 68 (9.1%) and 62 (8.3%) patients, respectively. Granulomas were significantly associated with lower T classification, N classification, and overall TNM stage (p  = 0.014, p = 0.006, and p = 0.001, respectively). Their presence was an independent predictor of overall survival (p = 0.033), disease-fr...
Source: Head and Neck Pathology - June 19, 2020 Category: Pathology Source Type: research

Salivary-Like Tumors of the Thyroid: A Comprehensive Review of Three Rare Carcinomas
AbstractThyroid carcinomas represent 3.2% of all new cases of cancer in the United States. Whereas most thyroid tumors arise from follicular cells or, less commonly, parafollicular cells, the derivation of some rare primary thyroid carcinoma subtypes is less clear and represents an area of evolving knowledge. Primary thyroid carcinomas that resemble neoplasms characteristic of the salivary glands ( “salivary-like” primary thyroid carcinomas) arguably represent some of the most unusual primary thyroid tumors. Herein, we have undertaken a review of the literature in order to present a comprehensive overview of sa...
Source: Head and Neck Pathology - June 19, 2020 Category: Pathology Source Type: research

Orbit Solitary Fibrous Tumor: A Proposed Risk Prediction Model Based on a Case Series and Comprehensive Literature Review
In conclusion, orbital SFTs are rare, but can be reliably diagnosed based on the presence of characteristic morphologic features and STAT6 immunohistochemistry. Orbital tumors tend to show a higher frequency of local recurrence than distant metastasis, which can be predicted by a risk stratification model unique to orbital tumors. With late disease common, long term clinical follow-up is recommended. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - June 11, 2020 Category: Pathology Source Type: research

Perithyroidal Salivary Gland Acinic Cell Carcinoma: Morphological and Molecular Attributes of a Unique Lesion
We report for the first time a case of primary salivary acinic cell carcinoma (AcCC) adjacent to the thyroid gland in a 71-year-old female patient with Crohns disease and a previous history of malignant melanoma. Following the development of a nodule adjacent to the left thyroid lobe, a fine-needle aspiration biopsy was reported as consistent with a follicular lesion of undetermined significance (Bethesda III). A left-sided hemithyroidectomy was performed. A circumscribed lesion measuring 33 mm was noted adjacent to the thyroid and trapping parathyroid, it was composed of solid nests and glands with microcystic and follicu...
Source: Head and Neck Pathology - June 9, 2020 Category: Pathology Source Type: research

Does Mixed Neuroendocrine-Nonneuroendocrine Neoplasm (MiNEN) of the Parathyroid Gland Exist? First Description of a Possible Case
We describe the histological, histochemical, and immunohistochemical features of an unusual neoplasm of the parathyroid gland showing the histologic criteria of a mixed neuroendocrine-nonneuroendocrine neoplasm (MiNEN). To the best of our knowledge, this is the first report of such a tumor. A 43-year old male presented with acute and severe abdominal pain due to acute pancreatitis. On physical examination a painless lump in the right neck was detected and laboratory analyses revealed hyperparathyroidism (parathormone: 146  pmol/L, normal range 1.05–6.83) and hypercalcemia (calcium level: 3.02 mg/dL, normal ...
Source: Head and Neck Pathology - June 6, 2020 Category: Pathology Source Type: research

Odontogenic Myxoma: A 23-Year Retrospective Series of 38 Cases
Abstract Odontogenic myxoma (OM) is an uncommon benign odontogenic tumor arising in the jaw. Though it has slight histologic overlap with other entities, definitive diagnosis is imperative considering the tumor ’s aggressive nature, high recurrence rate, and necessity of radical surgical intervention in large-sized lesions. With IRB approval, a retrospective search of the University of Florida College of Dentistry Oral Pathology Biopsy Service archives from 1994 to 2017 for diagnosis of OM of the j aw was performed. Biopsy reports and original slides for each case were assessed and reviewed along with any accompa...
Source: Head and Neck Pathology - June 6, 2020 Category: Pathology Source Type: research

Retrospective Study of Buccal Mucosal Salivary Neoplasms
This study with respect to demographics and percentage of benign and malignant buccal mucosal salivary gland neoplasms is in conformity with the literature. It underscores the fact that both benign and malignant salivary gland neoplasms should be included in the differential diagnosis of submucosal buccal masses. Future larger multicenter studies with detailed treatment and outcomes data may aid and assist in further understanding the behavior, diverse histomorphology and prognosis of these neoplasms. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - June 6, 2020 Category: Pathology Source Type: research

Pericyte in Oral Squamous Cell Carcinoma: A Systematic Review
The objective of the present study was to survey the scientific literature for conclusive evidence about whether pericytes are part of blood vessels in oral squamous cell carcinoma (OSCC) and their roles in the tumor microenvironment and clinical outcomes. A systematic electronic search was undertaken in Medline Ovid, PubMed, Web of Science, and Scopus. Eligibility criteria were: publications adopting in vivo models of OSCC that included pericyte detection and assessment by pericyte markers (e.g., α-smooth muscle actin, neuron-glial antigen 2 and platelet-derived growth factor receptor-β). The search yielded sev...
Source: Head and Neck Pathology - June 6, 2020 Category: Pathology Source Type: research

FET(EWSR1)-TFCP2 Rhabdomyosarcoma: An Additional Example of this Aggressive Variant with Predilection for the Gnathic Bones
AbstractAn example of a mandibular rhabdomyosarcoma in a 15-year-old male is described featuring EWSR1-TFCP2 fusion with homolateral lymph node metastasis and apparent metastasis to the thoracic vertebra T7. This type of rhabdomyosarcoma has preference for the craniofacial skeleton. Histologically, the tumor was composed of spindle and epithelioid cells characterized by nuclear pleomorphism, cytologic atypia and brisk mitotic activity. Immunohistochemically, it featured diffuse positive nuclear staining MYOD1, only focal staining for myogenin and patchy cytoplasmic staining for desmin. Tumor cells were positive for keratin...
Source: Head and Neck Pathology - June 5, 2020 Category: Pathology Source Type: research

YAP1-MAML2-Rearranged Poroid Squamous Cell Carcinoma (Squamoid Porocarcinoma)  Presenting as a Primary Parotid Gland Tumor
AbstractPorocarcinoma (synonym: malignant eccrine poroma) is a rare aggressive carcinoma type with terminal sweat gland duct differentiation. The squamous variant of porocarcinoma is even less frequent and might be indistinguishable from conventional squamous cell carcinoma (SCC). We herein describe the first case of a carcinoma presenting as a primary parotid gland malignancy in a 24-year-old male without any other primary tumor. Total parotidectomy and neck dissection were performed followed by adjuvant chemoradiation. The patient remained alive and well 10  months after diagnosis. Histology showed keratinizing SCC ...
Source: Head and Neck Pathology - June 5, 2020 Category: Pathology Source Type: research

Rosai –Dorfman Disease: A Rare Clinicopathological Presentation and Review of the Literature
We report an unusual presentation of R DD with cervical lymphadenopathy and an incidentally discovered sinonasal mass, clinically worrisome for malignancy. We emphasize that a high index of clinical suspicion is critical for accurate diagnosis of RDD. Clinicians and pathologists should consider RDD in a differential diagnosis of cervical lymphadenopathy, especially in young patients. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - June 5, 2020 Category: Pathology Source Type: research

Segmental Ipsilateral Odontognathic Dysplasia (Mandibular Involvement in Segmental Odontomaxillary Dysplasia?) and Identification of PIK3CA Somatic Variant in Lesional Mandibular Gingival Tissue
AbstractSegmental odontomaxillary dysplasia (SOD) is a developmental condition of the middle and posterior maxilla featuring dysplastic bone overgrowth, dental abnormalities and, occasionally, various homolateral cutaneous manifestations. Herein, we describe an individual with maxillary abnormality akin to SOD and associated ipsilateral segmental odontomandibular dysplasia. Also, the result of the evaluation of lesional mandibular gingival tissue for overgrowth-related gene variants is reported. An 8-year-old girl presented clinically with congenital maxillary and mandibular alveolar soft tissue enlargement in the area of ...
Source: Head and Neck Pathology - June 4, 2020 Category: Pathology Source Type: research

Signet Ring Cell Differentiation in Salivary Duct Carcinoma with Rhabdoid Features: Report of Three Cases and Literature Review
AbstractSalivary duct carcinoma with rhabdoid features (SDCRF) is a rare salivary tumor with poor prognosis and is proposed as a salivary counterpart of pleomorphic lobular carcinoma of the breast (PLCB). Here, we report three cases of SDC with rhabdoid features (SDCRF) mimicking PLCB. Pleomorphic adenoma (PA) component was accompanied in all the cases confirming carcinoma ex PA. One patient had frequent rhabdoid features and showed invasive growth into the surrounding tissue. The other two patients had intracapsular tumor but with rhabdoid features. The patients with intracapsular SDCRF survived for  >  5...
Source: Head and Neck Pathology - June 2, 2020 Category: Pathology Source Type: research

The Significance of Relative Claudin Expression in Odontogenic Tumors
The objectives of this study were to analyze the claudin-1, -4 and -7 expression in odontogenic tumors and characterize their expression pattern in distinct tumor cell types in relation to the recurrence potential. Sixty-nine cases of odontogenic tumors, including 43 ameloblastomas (AM), 17 adenomatoid odontogenic tumors (AOT), 6 ameloblastic fibromas (AF) and 3 ameloblastic carcinomas (AC) were investigated for claudin-1, -4 and -7 expression immunohistochemically. The staining was analyzed semi-quantitatively and categorized into 4 levels, based on the percentage of positively stained neoplastic epithelial cells. Claudin...
Source: Head and Neck Pathology - May 18, 2020 Category: Pathology Source Type: research

SMARCB1 (INI-1)-Deficient Adenocarcinoma of the Sinonasal Tract: A Potentially Under-Recognized form of Sinonasal Adenocarcinoma with Occasional Yolk Sac Tumor-Like Features
We present a dedicated series of 12 SMARCB1-deficient SNACs. All tumors had an oncocytoid/plasmacytoid cytomorphology with variable degrees of glandular differentiation consisting of tubules and cribriform structures with foci of intracellular or intraluminal mucin. Three of 12 tumors exhibited foci of yolk sac tumor-like histologic features. The tumors were uniformly high-grade, with nuclear pleomorphism, elevated mitotic rates and frequent necrosis. By immunohistochemistry, all tumors were entirely SMARCB1-deficient, and 10 of 12 were CK7-positive. Occasional expression of CDX2 (4 of 12), CK20 (3 of 12), and p40 (3 of 10...
Source: Head and Neck Pathology - May 18, 2020 Category: Pathology Source Type: research

Sporadic Neurofibroma of the Tongue Unassociated with Neurofibromatosis Type I: A Clinicopathologic Study of Ten Cases
AbstractNeurofibromas rarely occur within the oral cavity and infrequently involve the tongue. The majority of lingual neurofibromas arise in patients affected by neurofibromatosis type 1 (NF1). Neurofibromas of the tongue unassociated with this disorder are exceedingly uncommon. The clinical and pathologic features of 10 cases of sporadic lingual neurofibromas, unassociated with NF1, were evaluated. The patients included six females and four males ranging in age from 30 to 69  years (mean 59 years; median 63 years). An asymptomatic or slowly enlarging lingual mass was the most common clinical presentation. ...
Source: Head and Neck Pathology - May 18, 2020 Category: Pathology Source Type: research

Variability of CD34 Expression in Sinonasal Glomangiopericytoma: A Potential Diagnostic Pitfall
AbstractSinonasal glomangiopericytoma (GPC) is an uncommon primary sinonasal neoplasm showing a perivascular myoid differentiation. Originally perceived as an intranasal counterpart to soft tissue hemangiopericytomas, initial immunohistochemical reports showed mostly negative to focal weak reactivity for CD34 as useful in separating GPC (almost always benign) from morphologic mimics, mainly solitary fibrous tumor (potentially aggressive). In anecdotally encountering cases of GPC with CD34 reactivity beyond the expected weak/negative immunoprofile, we sought to formally evaluate CD34 staining in 10 cases of GPC from two dif...
Source: Head and Neck Pathology - May 18, 2020 Category: Pathology Source Type: research

Multiple Orthokeratinized Odontogenic Cysts: A Report of Two Cases and Review of the Literature
AbstractOrthokeratinized odontogenic cysts (OOC) are developmental odontogenic cysts characterised by an orthokeratinized stratified squamous epithelial lining. They were originally believed to be part of the spectrum of Odontogenic Keratocyst, but are now considered to be a distinct entity. They are rare, making up approximately 1% of all odontogenic cysts and they usually occur singly. In this paper we present two new cases of multiple OOCs, and compare them to previous case reports of multiple lesions. The clinical and pathological features are discussed, along with possible diagnostic pitfalls. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - May 18, 2020 Category: Pathology Source Type: research

Calcifying Fibrous Tumor of the Neck
This article describes a case of CFT which presented as an enlarging neck mass in a young male. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - May 18, 2020 Category: Pathology Source Type: research

Giant Cell Tumour of Temporal Bone and Infratemporal Fossa: A Rare Case
We report a rare case of giant cell tumour of the squamous portion of the temporal bone extending to the infratemporal fossa in a 38-year old male. The patient presented with progressive trismus, and swelling and pain in the right temporal region. The patient underwent excision of the mass by maxillary swing approach. The treatment of choice for GCT is complete surgical excision. Based on the location and extent of the GCT in the infratemporal fossa, several surgical approaches have been tried for its excision. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - May 18, 2020 Category: Pathology Source Type: research

Multifocal Parotid Oncocytic Cystadenomatosis: A Rare Process that Can Mimic Malignancy
We report the unique case of a 66-year-old male who previously underwent a superficial left parotidectomy for a pleomorphic adenoma. Four years later, he presented with clinical and radiographic suspicion of a multifocal recurrent pleomorphic adenoma. The patient subsequently underwent a revision parotidectomy. However, final pathology confirmed a diagnosis of MCO. Although MCO is commonly treated with surgery due to lack of a definitive preoperative diagnosis, surgery is unnecessary outside of diagnostic, functional or cosmetic considerations. Thus, if a patient with parotid oncocytosis treated by superficial parotidectom...
Source: Head and Neck Pathology - May 14, 2020 Category: Pathology Source Type: research

Well-Differentiated/Dedifferentiated Liposarcoma Arising in the Upper Aerodigestive Tract: 8 Cases Mimicking Non-adipocytic Lesions
AbstractWell-differentiated (WDL) and dedifferentiated liposarcomas (DL) of the pharynx, larynx and oral cavity are rare, often mimicking benign lipomatous neoplasms or non-lipogenic mesenchymal tumors. Cases of WDL/DL arising in the upper aerodigestive tract, exclusive of the cervical esophagus, were reviewed. Morphologic features, ancillary studies, including fluorescence in situ hybridization (FISH) studies forCPM/MDM2, and clinical data was catalogued. Eight WDL/DL (4 WDL, 4 DL); were identified in patients ranging from 32 to 77 years (median 52.5 years; 6 males, 2 females) with sites of origin including hypopharynx (5...
Source: Head and Neck Pathology - May 14, 2020 Category: Pathology Source Type: research

Laryngeal Contact Ulcer
AbstractA 47-year-old man presented to the otolaryngology service with complaint of 6  months of intermittent globus sensation. He reported constant throat clearing and subjective lowering of his voice. Flexible nasolaryngoscopy revealed a large pedunculated mass originating from the left vocal process of the arytenoid, lying superior to the vocal fold. The patient was treated conse rvatively with an anti-reflux regiment and speech language therapy for 2 months, however he noted marginal worsening in voice over the proceeding interval with an increasing raspy quality. He underwent suspension microlaryngoscopy wit...
Source: Head and Neck Pathology - May 7, 2020 Category: Pathology Source Type: research

Expanding Awareness of the Distribution and Biologic Potential of Ectomesenchymal Chondromyxoid Tumor
AbstractEctomesenchymal chondromyxoid tumor is a rare neoplasm of uncertain histogenesis that typically occurs in the anterior dorsal tongue. Recent reports in the literature have described rare examples of gingival, palatal and tonsillar lesions. Histologically, ectomesenchymal chondromyxoid tumors are typically well-circumscribed, lacking overtly aggressive features. Herein we report a tumor arising in the right mandible that is morphologically and molecularly consistent with ectomesenchymal chondromyxoid tumor. This case furthers awareness of the extra-glossal distribution of this neoplasm; moreover, it suggests that a ...
Source: Head and Neck Pathology - May 5, 2020 Category: Pathology Source Type: research

Comparison of Molecular Methods and BRAF Immunohistochemistry (VE1 Clone) for the Detection of BRAF V600E Mutation in Papillary Thyroid Carcinoma: A Meta-Analysis
This study included 4079 PTCs representing data from 23 studies. The results extracted from each study were split into two different groups, direct sequencing group or PCR group, based on the molecular “gold standard” method used to compare VE1 IHC staining. In the direct sequencing group, the IHC sensitivity was 100% (95% CI 0.97–1.00) and specificity 84% (95% 0.72–0.91). In the PCR group the sensitivity was 98% (95% CI 0.96–0.99) and specificity 89% (95% CI 0.82 –0.94). Although immunohistochemical procedures varied by author, the overall performance of the VE1 clone shows that it is h...
Source: Head and Neck Pathology - May 1, 2020 Category: Pathology Source Type: research

Increased ERBB2 Gene Copy Numbers Reveal a Subset of Salivary Duct Carcinomas with High Densities of Tumor Infiltrating Lymphocytes and PD-L1 Expression
AbstractSalivary duct carcinoma (SDC) commonly expresses androgen receptor (AR) and HER2, giving rise to treatment implications. SDC may also express programmed-death-ligand-1 (PD-L1), a predictive marker of response to checkpoint inhibitors. PD-L1 can be associated with genomic instability and high density of tumor infiltrating lymphocytes (TILs). Evaluation of HER2 immunohistochemistry (IHC) in SDC is not standardized, and relationships between ERBB2 copy numbers, PD-L1 expression and TILs in SDC are unknown. We evaluated 32 SDCs for HER2, AR and PD-L1 expression (IHC), ERBB2 status (FISH) and TILs (slide review). HER2 w...
Source: Head and Neck Pathology - April 29, 2020 Category: Pathology Source Type: research

Metastatic HPV-Associated Oropharyngeal Versus Primary Pulmonary Squamous Cell Carcinoma: is p16 Immunostain Useful?
This study attempts to define p16 immunoexpression and presence of HPV in primary SCC of the lung and determine their usefulness in discriminating between primary lung SCC and metastasis from HPV-associated oropharyngeal primary. Pathology archives were searched for patients with SCC of the lung without SCC elsewhere. Tissue microarray was constructed and immunohistochemistry performed using anti-p40 and anti-p16 antibodies. All cases were tested for HPV viral proteins E6/E7 by RNA in situ hybridization (ISH) and available positive cases for HPV DNA by polymerase chain reaction (PCR). Eight of 25 (32%) showed cytoplasmic a...
Source: Head and Neck Pathology - April 29, 2020 Category: Pathology Source Type: research

Primary Parotid Merkel Type Small Cell Neuroendocrine Carcinoma with Oligometastasis to the Brain and Adrenal Gland: Case Report and Review of Literature
AbstractOligometastatic disease is a hypothesized intermediate stage of disease between localized and widespread metastatic cancer. Localized treatment of oligometastatic lesions may offer survival advantages in addition to systemic treatment. In this case report, we describe a patient who presented with small cell neuroendocrine carcinoma “Merkel type” (SNECM) of the parotid gland which had metastasized to the brain and adrenal gland. He was treated with chemotherapy followed by stereotactic radiotherapy and volumetric modulated arc therapy for oligometastasis. He maintains good functional status with low burd...
Source: Head and Neck Pathology - April 29, 2020 Category: Pathology Source Type: research

Lymphoma Mimicking Chronic Active Epstein-Barr Virus: A Case Report
We describe a case of a previously healthy 34-year-old man who presented with non-tender, enlarging, right cervical lymphadenopathy for over a year that was associated with significant weight loss, fevers, and night sweats. Two fine needle core biopsies showed inconclusive then reactive tissue, respectively. A third excisional biopsy demonstrated a reactive lymph node with EBV-positive IM. There was no evidence of lymphoma by histologic examination or flow cytometry. A diagnosis of chronic active EBV (CAEBV) was rendered. Subsequent lymph node debulking six months later showed classic Hodgkin lymphoma (CHL) positive for EB...
Source: Head and Neck Pathology - April 29, 2020 Category: Pathology Source Type: research

Aggressive Intraosseous Myofibroma of the Maxilla: Report of a Rare Case and Literature Review
We reported a case of an aggressive intraosseous lesion found in the maxilla of a 9-year-old female child. Intraorally, the swelling extended from tooth 12 to 16, causing displacement of teeth 13, 14, and 15. Computed tomography revealed a large osteolytic lesion causing thinning and cortical erosion. Microscopically, the lesion showed a proliferation of spindle-shaped cells, with elongated nuclei and eosinophilic cytoplasm, arranged in interlaced fascicles. The immunohistochemical analysis revealed cytoplasmic positivity for α-SMA and HHF-35, and negativity for desmin, laminin, S-100, β-catenin, and CD34. Ki-67...
Source: Head and Neck Pathology - April 25, 2020 Category: Pathology Source Type: research

Prevalence of Lymphoid Neoplasia in a Retrospective Analysis of Warthin Tumor: A Single Institution Experience
AbstractWarthin tumor is one of the most common benign salivary gland tumors. Overt lymphoma is known to occur in the lymphoid stroma of Warthin tumor. In situ follicular neoplasia is difficult to identify in routine histologic examination of lymphoid tissue and has not been reported in association with Warthin tumor. Our objective is to determine the prevalence of overt malignant lymphoma and in situ follicular neoplasia in Warthin tumor. We conducted a retrospective histological evaluation of 89 sequential Warthin tumor cases with available slides and blocks from the years 2010 –2019. Of these, 84 cases were subjec...
Source: Head and Neck Pathology - April 23, 2020 Category: Pathology Source Type: research

Concomitant Congenital Intraoral Dermoid Cyst and Heterotopic Gastrointestinal Cyst
We present a case of 1-month-old neonate with a cystic ventral tongue mass that on histologic examination showed a dermoid cyst with co-existing heterotopic gastric-type epithelium in the wall. Additional histochemical stains revealed focal areas of colonic metaplasia within the heterotopic gastric epithelium. CDX2 immunohistochemical staining confirmed derivation from colonic epithelium. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - April 13, 2020 Category: Pathology Source Type: research

Identification of Rare and Common HPV Genotypes in Sinonasal Papillomas
AbstractSinonasal papillomas are rare, usually benign tumors arising from the Schneiderian membrane. Human papillomaviruses (HPV) can infect differentiating skin and mucosal cells and can induce uncontrolled growth patterns. Their effect on development of sinonasal papillomas has been discussed controversially in recent years. A monocentric, retrospective study was conducted to investigate histopathologic features of sinonasal papillomas and to establish an assay for HPV detection and genotyping in papillomas. Schneiderian papillomas are divided into three groups according to histopathologic features: the largest group are...
Source: Head and Neck Pathology - April 11, 2020 Category: Pathology Source Type: research

Plexiform Schwannoma of the Oral Cavity: Report of Eight Cases and a Review of the Literature
AbstractPlexiform schwannoma represents an unusual schwannoma variant, characterized by multinodular growth grossly and/or microscopically. A review of the English-language literature reveals only 28 previously reported cases involving the oral cavity, and herein we present 8 additional cases. Among these 36 patients, the average age at diagnosis was 28 years (range 5 to 62 years), with a female-to-male ratio of 1.4:1. The most frequently involved sites were the tongue (n  = 13) and lip (n = 11). Lesion duration prior to presentation averaged 5.3 years (range, 6 weeks to 26 years). The average l...
Source: Head and Neck Pathology - April 8, 2020 Category: Pathology Source Type: research

Benign and Malignant Granular Cell Tumor of the Hypopharynx: Two Faces of a Rare Entity
This report highlights the importance of complete excision of the tumor mass, as diagnosis of mGCT can be exceedingly difficult to make on a small biopsy specimen. Therefore, complete excision is recommended for definitive diagnosis and treatment of GCTs. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - April 2, 2020 Category: Pathology Source Type: research

Variable Expression of S100 Protein in Sinonasal Malignant Mucosal Melanoma: A Potential Diagnostic Pitfall
AbstractSinonasal malignant mucosal melanoma (SNM) is a rare, aggressive malignancy. The diagnosis of SNM is often quite challenging due to anatomical limitations, frequent lack of pigmentation, variable histologic appearances, and aberrant differentiation (e.g., positivity for cytokeratin, desmin, or neuroendocrine markers). S100 protein is routinely used as a standard screening marker for SNM, but it may lack optimal sensitivity. Our objective was to study the extent of immunohistochemical expression of S100 protein in SNM, and determine its diagnostic value by comparing it to a newer melanoma marker, SOX10. Twenty-three...
Source: Head and Neck Pathology - April 1, 2020 Category: Pathology Source Type: research

Vestibular Schwannoma: What We Know and Where We are Heading
AbstractVestibular schwannoma (VS) is a Schwann cell-derived tumour arising from the vestibulocochlear nerve. Although benign, it represents a threat to intracranial structures due to mass effect and carries a small risk of malignant transformation. VS therefore represents an important healthcare burden. We review the literature regarding pathogenesis, risk factors, and diagnosis of VS. The current and future potential management strategies are also discussed. A narrative review of all relevant papers known to the authors was conducted. The majority of VS remain clinically stable and do not require interventional procedure...
Source: Head and Neck Pathology - March 30, 2020 Category: Pathology Source Type: research

Pediatric Warthin-like Mucoepidermoid Carcinoma: Report of Two Cases with One Persistent/Recurrent as Conventional Mucoepidermoid Carcinoma
AbstractMucoepidermoid carcinoma (MEC) is the most common primary salivary gland malignancy. While salivary gland neoplasia is rare in children, MEC is much more likely to occur in the pediatric population than Warthin tumor, a common benign salivary gland neoplasm associated with smoking and older age. The recently-reported Warthin-like variant of MEC bears a striking histologic resemblance to Warthin tumor, representing a potential diagnostic pitfall. Therefore, low-power observation of Warthin-like features in pediatric salivary gland tumors should prompt careful diagnostic consideration of Warthin-like MEC. Two cases o...
Source: Head and Neck Pathology - March 27, 2020 Category: Pathology Source Type: research

Central Odontogenic Fibroma with Giant Cell Granuloma-Like Lesion: A Report of an Additional Case and Review of Literature
AbstractCentral odontogenic fibroma is a rare benign odontogenic tumor that relies on clinical –radiographic–histological correlation to reach its diagnosis, especially its rare variants. Of these rare types is the coexistence of giant cell granuloma-like lesion, with the characteristic odontogenic epithelial rests. The presented case is a 33 years old female complaining of asymptomatic m andibular bony swelling. Radiographically, the lesion is unilocular radiolucent, without root resorption. Histological examination revealed the presence of multinucleated giant cells within the diagnosed central odontogenic fi...
Source: Head and Neck Pathology - March 24, 2020 Category: Pathology Source Type: research

Tonsillar p16-Positive Follicular Dendritic Cell Sarcoma Mimicking HPV-Related Oropharyngeal Squamous Cell Carcinoma: A Case Report and Review of Reported Cases
AbstractFollicular dendritic cell sarcoma (FDCS) is a rare entity which can share morphologic features with non-keratinizing squamous cell carcinoma. Recent reports suggest that up to half of FDCSs show immunohistochemical positivity for p16 (Zhang et al., in Hum Pathol 66:40 –47, 2017), a stain that is conventionally used in the risk stratification of oropharyngeal squamous cell carcinoma (OPSCC). Herein, we report a case of p16-positive FDCS with clinical and histomorphologic overlap with human papilloma virus (HPV)-related OPSCC. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - March 18, 2020 Category: Pathology Source Type: research

Benign Alveolar Ridge Keratosis: Clinical and Histopathologic Analysis of 167 Cases
AbstractBenign alveolar ridge keratosis (BARK), the intraoral counterpart of cutaneous lichen simplex chronicus, is a reactive hyperkeratosis caused by trauma or friction that presents as a poorly demarcated white papule or plaque on the keratinized mucosa of the retromolar pad or alveolar ridge mucosa (often edentulous). This is a clinical and histopathologic analysis of BARK including evaluation of p53 expression in selected cases. One hundred and sixty-seven cases of BARK were identified from 2016 to 2017 and 112 (67.1%) occurred in males with a median age of 56  years (range 15–86). The retromolar pad was af...
Source: Head and Neck Pathology - March 16, 2020 Category: Pathology Source Type: research

Prevalence and Detection of Sexually Transmitted Cases of Laryngeal Carcinoma
This study investigates the association between HPV and LSCC as well as the roles for different immunohistochemical stains in HPV detection.MethodsA total of fifty-two formalin-fixed, paraffin-embedded tissue samples of LSCC, diagnosed between 2005 and 2015, were obtained from the archives of the Pathology Department. The samples were stained and processed to evaluate the relationship of HPV to LSCC.ResultsPatients had a mean age of 65.02  ± 14.341 years. By polymerase chain reaction (PCR), high-risk strains of HPV were detected in 15.4% of tissue samples. HPV-16 was found in 75% of the positive sample...
Source: Head and Neck Pathology - March 7, 2020 Category: Pathology Source Type: research

Laryngeal Dysplasia: Persisting Dilemmas, Disagreements and Unsolved Problems —A Short Review
We present the historical review and current state of the histopathological  classifications and terminology of laryngeal precursor lesions. Attention to recent genetic findings is also presented; although in need of additional confirmation, these raise possibility for early detection of patients at risk of dysplasia progression. Although a number of identified genetic alt erations with a promising diagnostic and prognostic value are emerging, none of the known genetic alterations can be currently implemented in clinical practice as a completely reliable diagnostic and/or prognostic marker. Regarding the terminol...
Source: Head and Neck Pathology - March 5, 2020 Category: Pathology Source Type: research

The Microenvironment of Head and Neck Cancers: Papillomavirus Involvement and Potential Impact of Immunomodulatory Treatments
AbstractCancer progression can be understood as the result of deregulation of tumors ’ immune microenvironments. Recent studies of the alterations of microenvironments highlight their significant influence on the prognosis of patients with head and neck squamous cell carcinoma (HNSCC). It is necessary to better characterize tumor-infiltrating lymphocytes by focusing, in particular , on the tumor escape mechanisms from immune surveillance. One of the best described tumor immune system evasion mechanisms is the expression of co-stimulation molecules that constitute so-called “immune checkpoints”. These mole...
Source: Head and Neck Pathology - March 2, 2020 Category: Pathology Source Type: research

Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features (NIFTP): An Update
AbstractBased on evidence accumulated over the past three decades showing that noninvasive encapsulated follicular variant of papillary thyroid carcinoma has an indolent clinical behavior and a RAS-like molecular profile similar to follicular adenoma, the Endocrine Pathology Society working group in 2016 proposed to rename this entity as “noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)” in order to eliminate the term “carcinoma” from the diagnosis. It is a major evidence-based attempt initiated by an international group of endocrine pathologists to tackle the epi...
Source: Head and Neck Pathology - March 2, 2020 Category: Pathology Source Type: research