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Head and Neck Pathology
Published in: Head and Neck Pathology 1/2012

01-07-2012 | Invited Review

Morphologic Features of Conventional Squamous Cell Carcinoma of the Oropharynx: ‘Keratinizing’ and ‘Nonkeratinizing’ Histologic Types as the Basis for a Consistent Classification System

Author: Rebecca D. Chernock

Published in: Head and Neck Pathology | Special Issue 1/2012

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Abstract

Morphologic assessment is one of the most basic tools that pathologists use to classify tumors. Human papillomavirus (HPV)-related squamous cell carcinoma of the oropharynx has unique morphologic features that can be readily recognized under the microscope. Yet, these features are not widely recognized or uniformly reported. In our practice, we group oropharyngeal squamous cell carcinomas into ‘nonkeratinizing’, ‘nonkeratinizing with maturation’, and ‘keratinizing’ histologic types. The ‘nonkeratinizing’ type has a very strong association with HPV, while the ‘keratinizing’ type has a weaker association with the virus. ‘Nonkeratinizing with maturation’ is intermediate but much more closely related to the ‘nonkeratinizing’ type. This classification system parallels that of sinonasal and nasopharyngeal squamous cell carcinomas where nonkeratinizing squamous cell carcinomas are widely recognized histologic variants. This review will discuss this classification system and its utility in routine clinical practice.
Literature
1.
Johnson N, Franceschi S, Ferlay J, Ramadas K, Schmid S, MacDonald DG, Bouquot JE, Slootweg PJ. Squamous cell carcinoma. In: Barnes L, Eveson JW, Reichart P, Sidransky D, editors. Pathology and genetics: head and neck tumours. Lyon: IARC Press; 2005. p. 168–75.
2.
Chernock RD, El-Mofty SK, Thorstad WL, Parvin CA, Lewis JS. HPV-related nonkeratinizing squamous cell carcinoma of the oropharynx: utility of microscopic featurtes in predicting patient outcome. Head Neck Pathol. 2009;3:186–94.PubMedCrossRef
3.
El-Mofty SK, Patil S. Human papillomavirus (HPV)-related oropharyngeal nonkeratinizing squamous cell carcinoma: characterization of a distinct phenotype. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:339–45.PubMedCrossRef
4.
El-Mofty SK, Lu DW. Prevalence of human papillomavirus type 16 DNA in squamous cell carcinoma of the palatine tonsil, and not the oral cavity in young patients: a distinct cllinicopathologic and molecular disease entity. Am J Surg Pathol. 2003;27(11):1463–70.PubMedCrossRef
5.
Mendelsohn AH, Lai CK, Shintaku IP, Elashoff DA, Dubinett SM, Abemayor E, St. John MA. Histopathologic findings of HPV and p16 positive HNSCC. Laryngoscope. 2010;120:1788–94.PubMedCrossRef
6.
Wilczynski SP, Lin BT, Xie Y, Paz IB. Detection of human papillomavirus DNA and oncoprotein overexpression are associated with distinct morphological patterns of tonsillar squamous cell carcinoma. Am J Pathol. 1998;152(1):145–56.PubMed
7.
Lewis JS Jr, Thorstad W, Chernock RD, Haughey BH, Yip JH, Zhang Q, El-Mofty SK. p16 positive oropharyngeal squamous cell carcinoma: an entity with a favorable prognosis regardless of tumor HPV status. Am J Surg Pathol. 2010;34(8):1088–96.PubMedCrossRef
8.
McHugh JB. Association of cystic neck metastases and human papillomavirus-positive oropharyngeal squamous cell carcinoma. Arch Pathol Lab Med. 2009;133:1798–803.PubMed
9.
Chernock RD, Lewis JS Jr, Zhang Q, El-Mofty SK. Human papillomavirus-positive basaloid squamous cell carcinomas of the upper aerodigestive tract: a distinct clinicopathologic and molecular subtype of basaloid squamous cell carcinoma. Hum Pathol. 2010;41:1016–23.PubMedCrossRef
10.
Begum S, Westra W. Basaloid squamous cell carcinoma of the head and neck is a mixed variant that can be further resolved by HPV status. Am J Surg Pathol. 2008;32(7):1044–50.PubMedCrossRef
11.
Wain SL, Kier R, Vollmer RT, Bossen EH. Basaloid-squamous carcinoma of the tongue, hypopharynx, and larynx: report of 10 cases. Hum Pathol. 1986;17(11):1158–66.PubMedCrossRef
12.
Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tan PF, Westra WH, Chung CH, Jordan RC, Lu C, Kim H, Axelrod R, Silverman CC, Redmond KP. Human papillomavirus and survival of patients wtih oropharyngeal cancer. N Eng J Med. 2010;363(1):24–35.CrossRef
13.
Weinberger PM, Yu Z, Haffty BG, Kowalski D, Harigopal M, Brandsma J, Sasaki C, Joe J, Camp RL, Rimm DL, Psyrri A. Molecular classification identifies a subset of human papillomavirus–associated oropharyngeal cancers with favorable prognosis. J Clin Oncol. 2006;24(5):736–47.PubMedCrossRef
14.
Lewis JS Jr, Khan RA, Masand RP, Chernock RD, Zhang Q, Al-Naief NS, Muller S, McHugh JB, Prasad M, Brandwein-Gensler M, Perez-Ordonez B, El-Mofty SK. Recognition of nonkeratinizing morphology in oropharyngeal squamous cell carcinoma-a prospective cohort and interobserver variability study. Histopathol. 2012;60(3):427–36.CrossRef
15.
Lewis JS Jr, Ukpo O, Ma XJ, Flanagan JJ, Luo Y, Thorstad WL, Chernock RD. Transcriptionally-active high-risk human papillomavirus is rare in oral cavity and laryngeal/hypopharyngeal squamous cell carcinomas-a tissue microarray study utilizing E6/E7 mRNA in situ hybridization. Histopathol. [Epub ahead of print].
16.
Westra WH. The changing face of head and neck cancer in the 21st century: the impact of HPV on the epidemiology and pathology of oral cancer. Head Neck Pathol. 2009;3:78–81.PubMedCrossRef
17.
Singhi AD, Califano J, Westra WH. High-risk human papillomavirus in nasopharyngeal carcinoma. Head Neck. 2012;34:213–8.PubMedCrossRef
18.
Maxwell JH, Kumar B, Feng FY, McHugh JB, Cordell KG, Eisbruch A, Worden FP, Wolf GT, Prince ME, Moyer JS, Teknos TN, Chepeha DB, Stoeker J, Walline H, Carey TE, Bradford CR. HPV-positive/p16-positive/EBV-negative nasopharyngeal carcinoma in white North Americans. Head Neck. 2009;32(5):562–7.
19.
El-Mofty SK, Lu DW. Prevalence of high-risk human papillomavirus in nonkeratinizing (cylindrical cell) carcinoma of the sinonasal tract: a distinct clinicopathologic and molecular disease entity. Am J Surg Pathol. 2005;29(10):1367–72.PubMedCrossRef
20.
Alos L, Moyano S, Nadal A, Alobid I, Blanch JL, Ayala E, Lloveras B, Quint W, Cardesa A, Ordi J. Human papillomaviruses are identified in a subgroup of sinonasal squamous cell carcinomas with favorable outcome. Cancer. 2009;115(12):2701–9.PubMedCrossRef
21.
Barnes L, Eveson JW, Reichart P, Sidransky D, editors. Pathology and genetics head and neck tumours. Lyon: IARC Press; 2005.
Metadata
Title
Morphologic Features of Conventional Squamous Cell Carcinoma of the Oropharynx: ‘Keratinizing’ and ‘Nonkeratinizing’ Histologic Types as the Basis for a Consistent Classification System
Author
Rebecca D. Chernock
Publication date
01-07-2012
Publisher
Springer US
Published in
Head and Neck Pathology / Issue Special Issue 1/2012
Electronic ISSN: 1936-0568
DOI
https://doi.org/10.1007/s12105-012-0373-4

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