P53 Gene Mutation Identified by Next Generation Sequencing in Poorly Differentiated Neuroendocrine Carcinoma of the Nasal Cavity
In this study, we performed next generation sequencing (NGS) using a targeted 161 cancer gene panel on a poorly differentiated NEC of the nasal cavity. The tumour was composed of large cells arranged in poorly formed glands and solid nests. The mitotic count rate was 30/10 HPFs and p53 protein was strongly expressed in all tumour cells. NGS identified a missense mutation, c.764T  >  G (p.Ile255Ser) in theTP53 gene with an allele frequency of 85%. This mutation results in an isoleucine to serine substitution and a non-functional protein. No other mutations were identified. These results suggest thatTP53 mut...
Source: Head and Neck Pathology - August 6, 2019 Category: Pathology Source Type: research

Papillary Carcinoma of Stensen ’s Duct with Intestinal Differentiation
We report a unique case of primary StDC with papillary features and intestinal differentiation of a 74-year-old male. We discuss the radiologic and pathologic correlation along with the dif ferential diagnosis of this rare entity. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - August 6, 2019 Category: Pathology Source Type: research

IgG4-Related Disease of the Thyroid Gland Requiring Emergent Total Thyroidectomy: A Case Report
AbstractIgG4-related disease of the thyroid gland is a recently recognized subtype of thyroiditis, often with rapid progression requiring surgical treatment. It is considered as a spectrum of disease varying from early IgG4-related Hashimoto ’s thyroiditis (HT) pattern to late fibrosing HT or Riedel’s thyroiditis patterns. Here, we report a 47-year-old Malay woman presenting with progressively painless neck swelling over 3 years and subclinical hypothyroidism. Computed tomography (CT) scan revealed diffuse thyroid enlargement (up t o 13 cm) with retrosternal extension and without regional lymphadenopa...
Source: Head and Neck Pathology - August 6, 2019 Category: Pathology Source Type: research

A Novel ALK – THBS1 Fusion in a Laryngeal Inflammatory Myofibroblastic Tumour: A Case Report and Literature Review
We present a case of a 23-year-old patient with a 5  month history of laryngitis and aphonia unresolved by corticotherapy. Laryngoscopy revealed a small, non-ulcerated, subepithelial, polypoid mass arising from the right vocal cord. The diagnosis of IMT with ALK expression was supported by histopathologic and molecular analysis. TheTHBS1 fusion partner was identified by RNA-sequencing analysis for the first time in a laryngeal IMT. This fusion partner has only been identified in six uterine IMTs thus far. Conservative excision of the lesion yielded excellent functional results for the patient. The voice was preserved ...
Source: Head and Neck Pathology - July 31, 2019 Category: Pathology Source Type: research

Extra Nodal Rosai-Dorfman Disease Originating in the Nasal and Paranasal Complex and Gnathic Bones: A Systematic Analysis of Seven Cases and Review of Literature
AbstractRosai-Dorfman disease (RDD) is a benign, self-limiting histiocytosis of unknown etiology. The classic form of the condition includes a painless cervical lymphaenopathy accompanied by fever, weight loss and an elevated ESR. Extra nodal RDD (ENRDD) is most frequent in the head and neck. Thirty-eight cases of ENRDD have been described. Seven cases of ENRDD were identified in our pathology biopsy services. The demographic and clinical information was tabulated logically on the basis of age, gender, location and presence or absence of symptoms, treatment and follow-up. Radiographic and histopathological features were al...
Source: Head and Neck Pathology - July 31, 2019 Category: Pathology Source Type: research

Ectopic ACTH Production and Cushing ’s Syndrome in a Patient with Parotid Acinic Cell Carcinoma with High-Grade Transformation: Tumor Context and Clinical Implications
We report a rare case of Cushing ’s syndrome in a 59-year-old man who initially presented with concurrent acinic cell carcinoma of the parotid with high-grade transformation and co-existing papillary and medullary thyroid carcinomas, without noticeable cushinoid symptoms. Six-months later, he developed clinical features of Cushin g’s syndrome which coincided with disease progression in the form of lung metastasis and mediastinal lymphadenopathy. Ectopic adrenocorticotropic hormone (ACTH) production and protein expression was limited to the high-grade transformed component of acinic cell carcinoma and in the lym...
Source: Head and Neck Pathology - July 30, 2019 Category: Pathology Source Type: research

The Prevalence, Anatomic Distribution and Significance of HPV Genotypes in Head and Neck Squamous Papillomas as Detected by Real-Time PCR and Sanger Sequencing
AbstractSquamous papillomas (SPs) of the head and neck are generally regarded as a human papillomavirus (HPV)-driven process, but reported rates of HPV detection vary dramatically. Moreover, they are generally considered a benign condition, but the detection of high risk HPV types is commonly reported. This latter finding is particularly disturbing to clinicians and their patients given the alarming rise of HPV-associated head and neck cancer. The capriciousness of HPV detection reflects in large part differences in methodologies. The purpose of this study was to review an institutional experience using a state of the art ...
Source: Head and Neck Pathology - July 27, 2019 Category: Pathology Source Type: research

Synchronous Calcifying Epithelial Odontogenic Tumor: Case Report and Analysis of the 5 Cases in the Literature
We present a case of synchronous CEOTs affecting the maxilla and mandible and describe the clinical, radiographic, histologic, and immunohistochemical features. We further review five cases previously described in the literature. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - July 27, 2019 Category: Pathology Source Type: research

Laryngeal Myxoglobulosis: A Rare Histologic Variant of Mucocele. The First Reported Case
AbstractMyxoglobulosis is a rare histologic variant of mucocele that is characterized by transformation of mucin into eosinophilic globules. The globules frequently demonstrate a lamellar pattern and are surrounded by an inflammatory cell infiltrate. Myxoglobulosis has not yet been described in laryngeal mucosa. A 62  year old man presented for a check-up with hoarseness of 2 months duration. He was a current smoker and reported a 40 year habit. An asymmetrical swelling along the length of both vocal cords was consistent with a clinical diagnosis of Reinke’s edema. The histopathologic examination demon...
Source: Head and Neck Pathology - July 27, 2019 Category: Pathology Source Type: research

Solitary Fibrous Tumors in the Head and Neck: Comprehensive Review and Analysis
AbstractSolitary fibrous tumors (SFT) arising in the head and neck region are uncommon yet well-recognized entities. Their biologic behavior and management still need to be elucidated. Systematically reviewing all published cases of SFT involving the head and neck region since 1991, a pooled meta-analysis was conducted to evaluate various demographic and tumor characteristics. 587 SFT in the head and neck have been reported; 343 met pooled analysis inclusion criteria. 61% of cases presented as a new mass; 89% were painless. Median onset of symptoms prior to evaluation was 8  months. Pre-operative local invasion and ma...
Source: Head and Neck Pathology - July 23, 2019 Category: Pathology Source Type: research

New Insights into Tumor Heterogeneity: A Case of Solid-Oncocytic Epithelial-Myoepithelial Carcinoma of the Parotid Gland Harboring a HRAS and Heterogeneous Terminating ARID1A Mutation
We report an unusual case of a low-grade EMC with prominent fibrous stroma, an extensive solid-oncocytic differentiation and limited areas of morphological clearly identifiable characteristic biphasic (tubular) differentiation, clear cells and PAS-positive secretions/calcifications. Both areas were investigated by next generation sequencing (Oncomine comprehensive assay) and revealed a typical concordantHRAS p.Q61R mutation. An additional heterogeneousARID1A (p.E672*) terminating mutation with loss of heterozygosity, which could be visualized predominantly in the solid-oncocytic differentiation by immunohistochemical loss ...
Source: Head and Neck Pathology - July 15, 2019 Category: Pathology Source Type: research

Central Giant Cell Granuloma Treated with Intralesional Corticosteroid Injections and Bisphosphonates: A Long-Term Follow-Up Case Study
We report a case of a 12-year-old female patient with a CGCG of the left maxilla that was treated with 40 doses of intralesional triamcinolone acetonide infiltrations combined with alendronate sodium and calcium carbonate. Clinical and imaging follow-up over 12  years demonstrates improvement in the patient’s condition. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - July 11, 2019 Category: Pathology Source Type: research

Primary Extranodal Nodular Lymphocyte Predominant Hodgkin Lymphoma Involving the Thyroid
We describe the first reported case involving the thyroid and review the six other previously described cases of primary extranodal NLPHL. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - July 10, 2019 Category: Pathology Source Type: research

(Mammary Analogue) Secretory Carcinoma of the Nasal Cavity: Report of a Rare Case with p63 and DOG1 Expression and Uncommon Exon 4 –Exon 14 ETV6 - NTRK3 Fusion Diagnosed with Next Generation Sequencing
We present a 72  years old male with a left nasal cavity (mammary analogue) secretory carcinoma (SC) which exhibited classical morphological features on light microscopical examination, diffuse strong S100 and mammoglobin positivity on immunohistochemistry, andETV6-NTRK3 gene fusion on next generation sequencing (NGS) analysis. Unusual features of this tumor are expression of p63 and DOG1 on immunohistochemistry and the atypical junction between Exon 4 of theETV6 gene and Exon 14 of theNTRK3 gene. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - July 4, 2019 Category: Pathology Source Type: research

Bradykinin Receptor B1 and C-Reactive Protein as Prognostic Factors for Pharyngocutaneous Fistula Development After Laryngectomy
This study aims to establish prognostic parameters to identify individual patients at risk for PCF development. As PCF and inflammation seem to be interwoven, this work focuses on markers able to detect an inflammatory response. We retrospectively analyzed all patients who had undergone a laryngectomy at our clinic in the years 2007 to 2017 (n  = 182). Immunohistochemical expression of bradykinin type 1 and 2 receptor and vascular endothelial growth factor receptor 2 was studied in all available tumor samples. Additionally, the clinical inflammation parameters ‘body temperature’, ‘pain&rsquo...
Source: Head and Neck Pathology - June 27, 2019 Category: Pathology Source Type: research

Pale (Clear) Cell Acanthoma of the Palate
In conclusion, we report an intraoral example of CCA in order to raise awareness about this entity. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - June 22, 2019 Category: Pathology Source Type: research

Practical Challenges in Measurement of Depth of Invasion in Oral Squamous Cell Carcinoma: Pictographical Documentation to Improve Consistency of Reporting per the AJCC 8th Edition Recommendations
AbstractDepth of invasion (DOI) and tumour thickness (TT) are known prognostic indicators in oral squamous cell carcinoma (OSCC), but varying definitions have been used by pathologists for reporting. The American Joint Committee on Cancer (AJCC) has proposed adoption of a uniform definition of DOI and incorporated this measurement in the revised TNM staging (8th edition); however, unambiguous DOI determination can be a challenge in clinical practice. We reviewed archived slides of 95 cases of T1/T2N0 OSCC and listed the challenges in accurate DOI measurement with pictographical documentation. The impacts of DOI and TT on d...
Source: Head and Neck Pathology - June 22, 2019 Category: Pathology Source Type: research

Incidence of Non-Salivary Gland Neoplasms in Patients with Warthin Tumor: A Study of 73 Cases
AbstractWarthin tumor is the second most common benign parotid neoplasm. Its association with non-salivary gland neoplasms has been sporadically reported. We reviewed clinical records of Warthin tumor diagnosed on aspiration cytology and surgical pathology to determine if there is any association with other extra-salivary gland malignant neoplasms. Computer search was made for all cases of Warthin tumor diagnosed in the parotid gland by aspiration cytology and surgical pathology at our institution between January 2007 and August 2016. Clinical records of all cases were reviewed for any associated malignant neoplasms and an...
Source: Head and Neck Pathology - June 21, 2019 Category: Pathology Source Type: research

SOX10 and GATA3 in Adenoid Cystic Carcinoma and Polymorphous Adenocarcinoma
AbstractDifferentiating between adenoid cystic carcinoma (AdCC) and polymorphous adenocarcinoma (PAC) can be difficult on small biopsies and cytologic specimens. As such, further characterization of their immunophenotype may aid in distinction. Previous studies have found AdCC to be SOX10+/GATA3 variable and PAC to be GATA3 negative. SOX10 expression in PAC has, as yet, not been established. We performed GATA3 and SOX10 immunohistochemistry on whole sections of 25 cases each of AdCC and PAC (including both classic PAC and the cribriform variant) to assess whether these markers are of diagnostic utility in distinguishing be...
Source: Head and Neck Pathology - June 20, 2019 Category: Pathology Source Type: research

An Evaluation of CD61 Immunohistochemistry in Identification of Vascular Invasion in Follicular Thyroid Neoplasms
This study aims to evaluate whether an immunohistochemical stain for the platelet-associated protein CD61 could assist in identifying tumor-associated thromboses and thereby confirm vascular invasion in follicular thyroid neoplasms. Histologic review and CD61 immunostaining of 19 atypical follicular adenomas, 13 non-metastatic follicular thyroid carcinomas, and 11 metastatic follicular thyroid carcinomas was performed. Linear arrays or clustered groups of CD61-expressing intravascular platelets were present in 51% of cases overall, including 54% of follicular thyroid carcinomas and 47% of follicular adenomas, mostly within...
Source: Head and Neck Pathology - June 19, 2019 Category: Pathology Source Type: research

Follicular Lymphoma Diagnosed in Warthin Tumor: A Case Report and Review of the Literature
We present a rare case of a 69-year-old man with systemic follicular lymphoma initially diagnosed in a Warthin tumor. Lymphomas occurring within Warthin tumors are rare, however, follicular lymphoma is most commonly reported. Because these patients require further treatment depending on the stage of a disease, it is important for a pathologist to review the histology of Warthin tumors diligently to identify occult lymphomas. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - June 10, 2019 Category: Pathology Source Type: research

Immunolocalization of IP3R and V-ATPase in Ameloblastomas
AbstractThe goal of this study was to investigate the immunolocalization of inositol 1,4,5-trisphosphate receptor (IP3R) and vacuolar ATPase (V-ATPase) in ameloblastomas with special attention to the invasive front. Thirty-seven cases of previously diagnosed formalin-fixed paraffin-embedded (FFPE) human ameloblastoma samples were selected for this study. The samples were grouped according to the predominant histologic pattern and comprised twelve plexiform, eighteen follicular, and seven unicystic ameloblastomas. Of the unicystic variants, six demonstrated purely luminal and intraluminal growth, and one displayed mural ext...
Source: Head and Neck Pathology - June 10, 2019 Category: Pathology Source Type: research

Poorly Differentiated Clusters Predict a Poor Prognosis for External Auditory Canal Carcinoma
AbstractSquamous cell carcinoma (SCC) of the external auditory canal (EAC) is rare and offers a poor prognosis; more accurate prognostic biomarkers are required. Our laboratory recently demonstrated that tumor budding, characterized by tumor cell clusters (
Source: Head and Neck Pathology - May 14, 2019 Category: Pathology Source Type: research

Sinonasal Ameloblastoma
AbstractAmeloblastomas are benign but aggressive odontogenic tumors that most commonly affect the posterior mandible. Approximately 15% occur in the maxilla, with a subset thought to originate from the epithelial lining of the sinonasal cavities. Histologically, sinonasal ameloblastomas are identical to those of the oral cavity, with classical features of palisaded columnar basilar cells surrounding a central proliferation that resembles the stellate reticulum of a developing tooth. Unlike the gnathic variant, sinonasal ameloblastomas tend to affect males more than females, and the incidence of diagnosis peaks at a later a...
Source: Head and Neck Pathology - May 14, 2019 Category: Pathology Source Type: research

Educational Impact of Trainee-Facilitated Head and Neck Radiology –Pathology Correlation Conferences
AbstractThe goal of this study was to evaluate the benefits of resident and fellow-facilitated radiology –pathology head and neck conferences. A total of seven resident-facilitated and six fellow-facilitated head and neck radiology–pathology cases were presented as part of the radiology department conference series. The radiology residents were surveyed regarding the perceived quality and effective ness of the fellow-facilitated sessions. The number of publications yielded from all the cases presented was tracked. Overall, the residents assessed the quality of the fellow-facilitated conferences with an average ...
Source: Head and Neck Pathology - May 14, 2019 Category: Pathology Source Type: research

An Analysis of Clinical and Histopathologic Features of Fibrous Dysplasia of the Jaws: A Series of 40 Cases and Review of Literature
This study serves to characterize the features of a large case series of FD of the jaws. With IRB approval, the University of Florida Oral Pathology Biopsy Service archive was retrospectively searched from 1994 to 2015 for cases of FD. Epidemiological data, location, duration, clinical and radiographic appearance, clinical impression and exact microscopic diagnosis were recorded. The average age was 37.3  years (range 7–87 years) with majority of cases in females (67.5%). The most common ethnicity was Caucasian. Maxillary location was predominant (59%), followed by mandible (38%) and multiple locations (3%)...
Source: Head and Neck Pathology - May 11, 2019 Category: Pathology Source Type: research

Infected Cemento-Osseous Dysplasia: Analysis of 66 Cases and Literature Review
AbstractThe aim of this study was to describe a series with 66 cases of infected cemento-osseous dysplasia (COD) and to discuss the demographic distribution, clinicoradiographic features and treatment of this condition. A study looking back on the diagnoses made at a single Brazilian centre within a 28-year timeframe was performed. A literature review with searches across five databases was also conducted to identify reports on osteomyelitis/infected COD. Descriptive and statistical analyses were performed. The case series study showed a female/male ratio of 21:1. Affected individuals ’ mean age was 57.4 years. ...
Source: Head and Neck Pathology - April 22, 2019 Category: Pathology Source Type: research

Patterns of LC3A Autophagy Protein Expression in Keratoacanthomas
AbstractTo investigate the expression patterns of autophagy marker light chain protein 3 (LC3A) in keratoacanthoma (KA). KAs are generally regarded as benign but malignant behavior, including rare metastases, may occur. 85 KAs were assessed for the LC3A autophagic protein by immunohistochemistry. Diffuse cytoplasmic staining and a “stone-like structure” (SLS) characterized positive expression. Thirty-four out of 85 KAs (40%) had diffuse cytoplasmic LC3A immunostaining (percentage of positive cells ranging from 5 to 60%). In contrast, only 4 of the 85 KAs (4.7%) expressed SLSs. Only one SLS was detected per hist...
Source: Head and Neck Pathology - April 11, 2019 Category: Pathology Source Type: research

Inter-observer Variability in the Diagnosis of Proliferative Verrucous Leukoplakia: Clinical Implications for Oral and Maxillofacial Surgeon Understanding: A Collaborative Pilot Study
This study demonstrates a lack of standardized terminology and diagnostic criteria for the spectrum of PVL lesions. We recommend adopting standardized criteria and terminology, proposed and established by an expert panel white paper, to assist pathologists and clinicians in uniformly diagnosing and managing PVL spectrum lesions. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - April 10, 2019 Category: Pathology Source Type: research

Schwannoma-Like Pleomorphic Adenoma: Two Cases and a Review of the Literature
AbstractSchwannoma-like pleomorphic adenoma is a rare variant of the common benign salivary neoplasm, pleomorphic adenoma. This entity ’s cytomorphology closely mimics a schwannoma, potentially making a diagnosis of cytologic preparations or of surgical specimens a challenge. To the best of our knowledge, there are only six previous reports of schwannoma-like pleomorphic adenoma with eight total cases in the English language lite rature prior to the addition of the two cases detailed in this report. Our report includes what we believe to be the first documented case of this entity occurring in the submandibular gland...
Source: Head and Neck Pathology - April 9, 2019 Category: Pathology Source Type: research

Low-Grade Fibromyxoid Sarcoma of the External Auditory Canal: A Rare Pathology and Unusual Location
We present a case of a 44-year-old female who presented with a superficial, polypoid mass of the external auditory meatus. Microscopic examination revealed the classic histologic features of HSTGR. To our knowledge, this case is the first described at this extremely unusual location. Identification and reporting of such unusual cases is important to understand and compare the behavior of superficial LGFMS to that of the more common deeply seated tumors. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - April 4, 2019 Category: Pathology Source Type: research

Salivary Duct Carcinoma of the Parotid Gland Originating from an Epithelial-Myoepithelial Carcinoma: Report of a Rare Case
In this study, we report a rare case of SDC of the parotid gland originating from an epithelial-myoepithelial carcinoma (EMC). A 71-year-old Japanese man presented with swelling of the right parotid region and a right facial nerve paralysis for 10  months. He underwent extended total parotidectomy and chemoradiotherapy after the surgery. Histologically, a major part of the tumor was an androgen receptor (AR)-positive, human epidermal growth factor receptor 2 (HER2)-positive, gross cystic disease fluid protein-15 (GCDFP-15)-positive SDC, with a focus of a typical EMC component at the periphery of the lesion. In the tra...
Source: Head and Neck Pathology - April 1, 2019 Category: Pathology Source Type: research

Regional Odontodysplasia Affecting the Maxilla
AbstractRegional odontodysplasia (RO) is a rare dental anomaly of unknown etiology that can affect both deciduous and permanent dentition. RO is characterized by severe hypoplasia of enamel and dentin, and teeth affected are friable and more susceptible to caries and fractures. Most of the lesions occur in the anterior maxilla and correlation with clinical and radiographic features is essential to provide a correct diagnosis. The major criteria for diagnosis are predominantly based on radiography, which shows presence of large pulp chambers and a marked reduction in the radiopacity of enamel and dentin, making the distinct...
Source: Head and Neck Pathology - March 21, 2019 Category: Pathology Source Type: research

Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features is Rare: A Population Based Study of Incidence
AbstractThe renaming of encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) to noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was proposed by a group of experts in 2016 to prevent overtreatment of indolent, low-risk thyroid cancers. The aim of this study was to estimate the incidence and outcome for patients meeting the NIFTP criteria in a well-defined geographic region. Our cohort consisted of 134 patients with papillary thyroid carcinoma from the Region of Southern Denmark (RSD), 2007 to 2011. Patients were retrieved from the Danish Thyroid Cancer (DATHYRCA) Datab...
Source: Head and Neck Pathology - March 21, 2019 Category: Pathology Source Type: research

Extranodal NK/T-Cell Lymphoma, Nasal Type in Guatemala: An 86-Case Series Emphasizing Clinical Presentation and Microscopic Characteristics
In this study, we describe a case series of 86 Guatemalan patients with ENKTCL-NT from a single  diagnostic head and neck center. We emphasize the distinctive clinical, microscopic, and immunohistochemical (IHC) features, as well as EBV positivity by in situ hybridization (ISH). Most of the patients (90.6%) were of Mayan descent and low socioeconomic status (SES). Males were more often aff ected than females, comprising 68.3% of cases. Patient age ranged from 8 to 71, with a mean of 34.7 years. All cases arose in the upper aerodigestive tract and mainly presented as a rapidly progressive, necrotizi...
Source: Head and Neck Pathology - March 21, 2019 Category: Pathology Source Type: research

Expanded Expression of Toll-Like Receptor 2 in Proliferative Verrucous Leukoplakia
AbstractProliferative verrucous leukoplakia (PVL) is a premalignant condition of the oral mucosa with>  70% chance of progression to squamous cell carcinoma (SCC), while lacking the common risks and behavior seen in non-PVL oral squamous carcinogenesis. PVL follows a multi-stage slow, relentless and usually multifocal expansion of surface epithelial thickening that over time takes on a verrucous ar chitecture, eventually leading to verrucous carcinoma and/or dysplasia followed by “conventional” SCC, a process that takes years and is notoriously difficult to manage. As mucosal surfaces and carcinomas a...
Source: Head and Neck Pathology - March 19, 2019 Category: Pathology Source Type: research

Hypopharyngeal Skin Cancer Following Total Laryngectomy and Pectoralis Flap Reconstruction: Case Report and Literature Review
We describe the case of a 62-year-old gentleman who underwent primary resection and adjuvant radiation therapy for supraglottic squamous cell carcinoma who subsequently underwent salvage total laryngectomy with pectoralis major muscle flap reconstruction. During a later esophageal dilation for complaints of dysphagia, a new exophytic lesion of the hypopharynx was biopsied on endoscopy. The lesion was excised via transoral robotic surgery with final pathology revealing squamous cell carcinoma completely confined to the skin paddle of the pectoralis flap and arising from the epidermis of the skin flap. No further therapy was...
Source: Head and Neck Pathology - March 19, 2019 Category: Pathology Source Type: research

Kikuchi –Fujimoto Disease and Prognostic Implications
We describe a follow-up algorithm for newly diagnosed KFD cases, based on the current literature. KFD is a rare cause of cervical lymphadenopathy. It is associated with increased risk of developing SLE, therefore early diagnosis and long-term follow-up are recommended. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - March 19, 2019 Category: Pathology Source Type: research

Lipoma of the Parotid Gland
(Source: Head and Neck Pathology)
Source: Head and Neck Pathology - March 19, 2019 Category: Pathology Source Type: research

Congenital Granular Cell Epulis: Classic Presentation and Its Differential Diagnosis
AbstractCongenital granular cell epulis (CGCE) is an uncommon lesion of unclear pathogenesis. It occurs predominantly in female newborns with a predilection site of the maxillary alveolar ridge. The mass enlarges prenatally but the growth arrests after birth. Histologically, CGCE is characterized by a proliferation of polygonal cells with eosinophilic, granular cytoplasm and eccentric, bland-appearing nuclei. It closely resembles adult granular cell tumor (GCT) microscopically and S-100 immunostain is often helpful in distinguishing the two (S-100-positive in GCT and S-100-negative in CGCE). Clinically, the lesion should a...
Source: Head and Neck Pathology - March 19, 2019 Category: Pathology Source Type: research

Current Challenges in the Staging of Oral Cancer
AbstractIn the recently published 8th edition of the AJCC Cancer Staging Manual, new pathological elements are required for the N and T category determinations for oral cavity cancers. This includes determination of depth of tumor invasion and assessment of metastatic lymph nodes for extranodal extension. Although definitions and some guidance are provided for the interpretation of these elements, pathologists frequently encounter ambiguous situations that may result in interobserver and intraobserver variability. Pre-existing staging elements, such as assessment of bone invasion, can also be problematic to interpret. Diff...
Source: Head and Neck Pathology - March 18, 2019 Category: Pathology Source Type: research

Benign Fibro-Osseous Lesions of the Head and Neck
AbstractBenign fibro-osseous lesions (BFOLs) are a particularly challenging set of diagnoses for the pathologist. This diverse collection of diseases includes fibrous dysplasia, ossifying fibroma and cemento-osseous dysplasia. While all three conditions have similar microscopic presentations, their treatment and prognosis differ, demanding an accurate and definitive diagnosis. A practical and systematic approach considering the patient ’s history, demographics, intraoperative presentation, and gross appearance with an emphasis on radiology and histology will be discussed. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - March 18, 2019 Category: Pathology Source Type: research

Oral Epithelial Dysplasia and Premalignancy
AbstractLeukoplakia and erythroplakia are two entities under the moniker of “oral potentially malignant disorders” that are highly associated with the presence of oral epithelial dysplasia (OED) at first biopsy, while lesions of submucous fibrosis develop OED after being present for years. Importantly, traumatic/frictional keratoses are often mistaken clinically for leu koplakia and it is important for the pathologist to recognize and report them as such. The features of OED have been well-described and other architectural features will be discussed here, in particular verrucous and papillary architecture, bulk...
Source: Head and Neck Pathology - March 18, 2019 Category: Pathology Source Type: research

Update on Odontogenic Tumors: Proceedings of the North American Head and Neck Pathology Society
AbstractOdontogenic tumors are rare entities, often derived from the epithelial remnants in the gnathic bones following odontogenesis. This brief manuscript will seek to address recent developments pertaining to odontogenic tumors as well as particularly uncommon odontogenic tumors and the difficulties in their diagnosis. (Source: Head and Neck Pathology)
Source: Head and Neck Pathology - March 18, 2019 Category: Pathology Source Type: research

Challenges in Minor Salivary Gland Biopsies: A Practical Approach to Problematic Histologic Patterns
AbstractEvaluation of minor salivary gland biopsy can be fraught with a wide range of problems, including technical limitations due to the small size and distorted nature of tissue received and interpretive difficulties navigating the considerable morphologic and immunohistochemical overlap between widely disparate entities. As such, common pathologic findings can evoke a perplexing differential diagnosis that encompasses malignant, benign, and non-neoplastic processes. This review will present the diagnostic considerations that arise from four histologic patterns that are frequently encountered on minor salivary gland bio...
Source: Head and Neck Pathology - March 18, 2019 Category: Pathology Source Type: research

Hamartoma of the Oral Cavity with Ectopic Meningothelial Elements in Infants: A Rare Entity with Report of Two Cases
In this report, we describe two infant patients with hamartoma with ectopic meningothelial elements involving tongue and maxillary alveolar ridge. To the best of our knowledge, these are the first two cases in which a meningothelial proliferation has been identified in the oral cavity. Hamartoma with ectopic meningothelial elements is a rare condition that has been classically described occurring in the scalp. These lesions are characterized by bland round to spindle-shape cells that interdigitate through collagen bundles and express progesterone receptor and epithelial membrane antigen by immunohistochemistry supporting a...
Source: Head and Neck Pathology - March 6, 2019 Category: Pathology Source Type: research

Calcifying Epithelial Odontogenic (Pindborg) Tumor in a Child: A Case Report and Literature Review
AbstractCalcifying epithelial odontogenic tumor (CEOT) is a rare neoplasm, which accounts for
Source: Head and Neck Pathology - February 15, 2019 Category: Pathology Source Type: research

Primary Tonsillar Epithelioid Follicular Dendritic Cell Sarcoma: Report of a Rare Case Mimicking Undifferentiated Carcinoma and a Brief Review of the Literature
We present a 52  years old male with a left tonsillar follicular dendritic cell sarcoma with prominent epithelioid features that on light microscopical examination bore a striking resemblance to a lymphoepithelial or undifferentiated carcinoma. The tumor was immunohistochemically positive for CD21 and CD35 and neg ative for cytokeratins. Two distinct histopathological features (both present in our case) that may serve as clues to the correct diagnosis on light microscopical examination were formation of ectatic pseudovascular spaces lined by malignant cells and the presence of non-neoplastic multinucleated gi ant cell...
Source: Head and Neck Pathology - February 13, 2019 Category: Pathology Source Type: research

Thyroid Gland Solitary Fibrous Tumor: Report of 3 Cases and a Comprehensive Review of the Literature
AbstractSolitary fibrous tumors of the thyroid gland are exceptionally rare. In order to further characterize the clinical and pathologic features of solitary fibrous tumor arising at this anatomic site, three cases of thyroid gland solitary fibrous tumor were analyzed in conjunction with 35 cases compiled from the English literature. Thyroid gland solitary fibrous tumors showed an equal sex distribution with a mean age at presentation of 54.4  years (range, 28–88 years). The patients typically presented with an asymptomatic, slow growing neck mass. Microscopically, the tumors were characterized by cytologi...
Source: Head and Neck Pathology - February 13, 2019 Category: Pathology Source Type: research

Vascular Floor of Mouth Mass with Unanticipated Intracranial, Orbital, and Vertebral Associated Involvements
We report on a case in which a blanching, unobtrusive oral growth proved to be a systemic threat. A blind, epileptic child presented with a bleeding oral floor mass of 4  weeks. Biopsy showed small, dilated vascular spaces with reactive fibroblasts. MRI indicated distribution of expansile lesions in the mandible, cranial base, and right orbit that had possibly contributed to the patient’s years-long neurologic deficits. A subsequent bone scan indicated lesions in multiple axial bones. Histologic markers confirmed the presentation of a rare cystic vascular pathology. Cystic Angiomatosis is a disease of intraosseo...
Source: Head and Neck Pathology - February 13, 2019 Category: Pathology Source Type: research