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Triantafyllou A, Mikkelsen LH, Gnepp DR, Andreasen S, Hunt JL, Devaney KO, Vander Poorten V, Rinaldo A, Willems SM, Ferlito A. Salivary myoepithelial cells: an addendum. Ultrastruct Pathol 2018; 42:465-476. [DOI: 10.1080/01913123.2018.1551259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Asterios Triantafyllou
- Department of Pathology, Liverpool Clinical Laboratories, Royal Liverpool University Hospital, Liverpool, UK
- School of Dentistry, University of Liverpool, Liverpool, UK
| | - Lauge Hjorth Mikkelsen
- Department of Pathology, Eye Pathology Section, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Ophthalmology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Douglas R. Gnepp
- Department of Pathology, Providence, Rhode Island, and Fall River, MA, USA
| | - Simon Andreasen
- Department of Pathology and Department of Otolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen
| | - Jennifer L. Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Vincent Vander Poorten
- Otorhinolaryngology-Head and Neck Surgery and Department of Oncology-Section Head and Neck Oncology, University Hospitals Leuven, Leuven, Belgium
- European Salivary Gland Society, Geneva, Switzerland
| | | | - Stefan M. Willems
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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2
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Bullock MJ, Beitler JJ, Carlson DL, Fonseca I, Hunt JL, Katabi N, Sloan P, Taylor SM, Williams MD, Thompson LDR. Data Set for the Reporting of Nodal Excisions and Neck Dissection Specimens for Head and Neck Tumors: Explanations and Recommendations of the Guidelines From the International Collaboration on Cancer Reporting. Arch Pathol Lab Med 2018; 143:452-462. [DOI: 10.5858/arpa.2018-0421-sa] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Standardized, synoptic pathologic reporting for tumors greatly improves communication among clinicians, patients, and researchers, supporting prognostication and comparison about patient outcomes across institutions and countries. The International Collaboration on Cancer Reporting is a nonprofit organization whose mission is to develop evidence-based, universally available surgical pathology reporting data sets. Within the head and neck region, lymph node excisions and neck dissections are frequently performed as part of the management of head and neck cancers arising from the mucosal sites (sinonasal tract, nasopharynx, oropharynx, hypopharynx, oral cavity, and larynx) along with bone tumors, skin cancers, melanomas, and other tumor categories. The type of specimen, exact location (lymph node level), laterality, and orientation (by suture or diagram) are essential to accurate classification. There are significant staging differences for each anatomic site within the head and neck when lymph node sampling is considered, most importantly related to human papillomavirus–associated oropharyngeal carcinomas and mucosal melanomas. Number, size, and site of affected lymph nodes, including guidelines on determining the size of tumor deposits and the presence of extranodal extension and soft tissue metastasis, are presented in the context of prognostication. This review elaborates on each of the elements included in the data set for Nodal Excisions and Neck Dissection Specimens for Head & Neck Tumours.
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Affiliation(s)
- Martin J. Bullock
- From the Department of Pathology, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada (Dr Bullock); the Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (Dr Beitler); the Pathology and Laboratory Medicine Institute, Cleveland Clinic, Weston, Florida (Dr Carlson); the Instituto de Anatomia Patológica, Faculd
| | - Jonathan J. Beitler
- From the Department of Pathology, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada (Dr Bullock); the Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (Dr Beitler); the Pathology and Laboratory Medicine Institute, Cleveland Clinic, Weston, Florida (Dr Carlson); the Instituto de Anatomia Patológica, Faculd
| | - Diane L. Carlson
- From the Department of Pathology, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada (Dr Bullock); the Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (Dr Beitler); the Pathology and Laboratory Medicine Institute, Cleveland Clinic, Weston, Florida (Dr Carlson); the Instituto de Anatomia Patológica, Faculd
| | - Isabel Fonseca
- From the Department of Pathology, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada (Dr Bullock); the Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (Dr Beitler); the Pathology and Laboratory Medicine Institute, Cleveland Clinic, Weston, Florida (Dr Carlson); the Instituto de Anatomia Patológica, Faculd
| | - Jennifer L. Hunt
- From the Department of Pathology, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada (Dr Bullock); the Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (Dr Beitler); the Pathology and Laboratory Medicine Institute, Cleveland Clinic, Weston, Florida (Dr Carlson); the Instituto de Anatomia Patológica, Faculd
| | - Nora Katabi
- From the Department of Pathology, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada (Dr Bullock); the Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (Dr Beitler); the Pathology and Laboratory Medicine Institute, Cleveland Clinic, Weston, Florida (Dr Carlson); the Instituto de Anatomia Patológica, Faculd
| | - Philip Sloan
- From the Department of Pathology, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada (Dr Bullock); the Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (Dr Beitler); the Pathology and Laboratory Medicine Institute, Cleveland Clinic, Weston, Florida (Dr Carlson); the Instituto de Anatomia Patológica, Faculd
| | - S. Mark Taylor
- From the Department of Pathology, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada (Dr Bullock); the Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (Dr Beitler); the Pathology and Laboratory Medicine Institute, Cleveland Clinic, Weston, Florida (Dr Carlson); the Instituto de Anatomia Patológica, Faculd
| | - Michelle D. Williams
- From the Department of Pathology, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada (Dr Bullock); the Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (Dr Beitler); the Pathology and Laboratory Medicine Institute, Cleveland Clinic, Weston, Florida (Dr Carlson); the Instituto de Anatomia Patológica, Faculd
| | - Lester D. R. Thompson
- From the Department of Pathology, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada (Dr Bullock); the Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (Dr Beitler); the Pathology and Laboratory Medicine Institute, Cleveland Clinic, Weston, Florida (Dr Carlson); the Instituto de Anatomia Patológica, Faculd
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3
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Triantafyllou A, Devaney KO, Hunt JL, Rinaldo A, Ferlito A. Structural biology of intraepithelial neuroendocrine cells in the larynx: Literature review. Pathol Res Pract 2018; 215:1-4. [PMID: 30396757 DOI: 10.1016/j.prp.2018.10.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 10/21/2018] [Accepted: 10/22/2018] [Indexed: 12/01/2022]
Abstract
Current knowledge of laryngeal neuroendocrine cells in man and other vertebrates is reviewed. Particular attention is paid to differences in the distribution of neuroendocrine cells between squamous and respiratory laryngeal mucosa, foetal versus post-natal spatial arrangements, relation to the laryngeal cavity and nerve fibres, and immunoreactivities of these cells. Methodological deficiencies and gaps in knowledge are outlined. Comparisons with neuroendocrine cells in lung and gut are drawn, caution with regard to existing histogenetic models of laryngeal neuroendocrine neoplasia is advised and lines of future research are suggested.
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Affiliation(s)
- Asterios Triantafyllou
- Department of Pathology, Liverpool Clinical Laboratories, Royal Liverpool University Hospital, Liverpool, UK; School of Dentistry, University of Liverpool, Liverpool, UK.
| | | | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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4
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Thomas Robbins K, Triantafyllou A, Suárez C, López F, Hunt JL, Strojan P, Williams MD, Braakhuis BJM, de Bree R, Hinni ML, Kowalski LP, Rinaldo A, Rodrigo JP, Vander Poorten V, Nixon IJ, Takes RP, Silver CE, Ferlito A. Surgical margins in head and neck cancer: Intra- and postoperative considerations. Auris Nasus Larynx 2018; 46:10-17. [PMID: 30172560 DOI: 10.1016/j.anl.2018.08.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 08/13/2018] [Accepted: 08/15/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To provide a perspective on the significance of recent reports for optimizing cancer free surgical margins that have challenged standard practices. METHODS We conducted a review of the recent literature (2012-2018) using the keywords surgical margin analysis, frozen and paraffin section techniques, head and neck cancer, spectroscopy and molecular markers. RESULTS Of significance are the reports indicating superiority of tumor specimen directed sampling of margins compared to patient directed (tumor bed) sampling for frozen section control of oral cancers. With reference to optimal distance between tumor and the surgical margin, recent reports recommended cutoffs less than 5mm. Employment of new technologies such as light spectroscopy and molecular analysis of tissues, provide opportunities for a "real time" assessment of surgical margins. CONCLUSIONS The commonly practiced method of patient directed margin sampling involving previous studies raises concern over conclusions made regarding the efficacy of frozen section margin control. The recent studies that challenge the optimal distance for clear surgical margins are retrospective and address patient cohorts with inherently confounding factors. The use of novel ancillary techniques require further refinements, clinical trial validation, and justification based on the additional resources.
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Affiliation(s)
- K Thomas Robbins
- Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA.
| | - Asterios Triantafyllou
- Liverpool Clinical Laboratories and School of Dentistry, University of Liverpool, Liverpool, UK
| | - Carlos Suárez
- Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
| | - Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, IUOPA, University of Oviedo, CIBERONC, Oviedo, Spain
| | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Michelle D Williams
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Remco de Bree
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Michael L Hinni
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Luiz P Kowalski
- Otorhinolaryngology-Head and Neck Surgery,Centro de Tratamento e Pesquisa Hospital do Cancer A.C. Camargo, São Paulo, Brazil
| | | | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, IUOPA, University of Oviedo, CIBERONC, Oviedo, Spain
| | - Vincent Vander Poorten
- Otorhinolaryngology-Head and Neck Surgery and Department of Oncology, Section Head and Neck Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Iain J Nixon
- Departments of Surgery and Otolaryngology, Head and Neck Surgery, Edinburgh University, Edinburgh, UK
| | - Robert P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carl E Silver
- Department of Surgery, University of Arizona College of Medicine, Phoenix, AZ, USA
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5
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Vander Poorten V, Triantafyllou A, Skálová A, Stenman G, Bishop JA, Hauben E, Hunt JL, Hellquist H, Feys S, De Bree R, Mäkitie AA, Quer M, Strojan P, Guntinas-Lichius O, Rinaldo A, Ferlito A. Polymorphous adenocarcinoma of the salivary glands: reappraisal and update. Eur Arch Otorhinolaryngol 2018; 275:1681-1695. [PMID: 29761209 DOI: 10.1007/s00405-018-4985-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 04/26/2018] [Indexed: 12/29/2022]
Abstract
Although relatively rare, polymorphous adenocarcinoma (PAC) is likely the second most common malignancy of the minor salivary glands (MiSG). The diagnosis is mainly based on an incisional biopsy. The optimal treatment comprises wide surgical excision, often with adjuvant radiotherapy. In general, PAC has a good prognosis. Previously, PAC was referred to as polymorphous low-grade adenocarcinoma (PLGA), but the new WHO classification of salivary gland tumours has also included under the PAC subheading, the so-called cribriform adenocarcinoma of minor salivary glands (CAMSG). This approach raised controversy, predominantly because of possible differences in clinical behaviour. For example, PLGA (PAC, classical variant) only rarely metastasizes, whereas CAMSG often shows metastases to the neck lymph nodes. Given the controversy, this review reappraises the definition, epidemiology, clinical presentation, diagnostic work-up, genetics, treatment modalities, and prognosis of PAC of the salivary glands with a particular focus on contrasting differences with CAMSG.
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Affiliation(s)
- Vincent Vander Poorten
- Department of Oncology-Section Head and Neck Oncology, Otorhinolaryngology-Head and Neck Surgery and Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium. .,Multidisciplinary Salivary Gland Society, Geneva, Switzerland.
| | - Asterios Triantafyllou
- School of Dentistry, University of Liverpool, Liverpool, UK.,Pathology Department, Liverpool Clinical Laboratories, Liverpool, UK
| | - Alena Skálová
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland.,Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, Czech Republic
| | - Göran Stenman
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland.,Department of Pathology and Genetics, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden
| | - Justin A Bishop
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Esther Hauben
- Department of Imaging and Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Henrik Hellquist
- Epigenetics and Human Disease Laboratory, CBMR, Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal
| | - Simon Feys
- Department of Oncology-Section Head and Neck Oncology, Otorhinolaryngology-Head and Neck Surgery and Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Remco De Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Antti A Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Miquel Quer
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland.,Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Orlando Guntinas-Lichius
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland.,Department of Otorhinolaryngology, Institute of Phoniatry/Pedaudiology, Jena University Hospital, Jena, Germany
| | | | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
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6
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Hellquist H, Hunt JL, Cardesa A, Skalova A, Slootweg PJ, Rinaldo A, Ferlito A. Role of ancillary techniques in profiling unclassified laryngeal malignancies. Virchows Arch 2018; 472:705-715. [PMID: 29623469 DOI: 10.1007/s00428-018-2348-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/09/2018] [Accepted: 03/26/2018] [Indexed: 12/31/2022]
Abstract
Laryngeal biopsies, contrary to biopsies from many other sites of the body, very often contain minute amounts of tumour tissue that may consist of morphologically undifferentiated tumour only. In haematoxylin- and eosin-stained sections, there may be no indicative features of what specific tumour entity that is present. In the larynx, particularly small round cell neoplasms, primary or metastatic, often cause a diagnostic dilemma and where an incorrect diagnosis can induce substantial clinical consequences for the patient (e.g., primary neuroendocrine carcinomas vs metastatic variants, certain sarcomas). If sufficient/representative material has been obtained, the application of immunohistochemistry and/or molecular techniques should in virtually every case reveal the true nature of the malignancy. In cases with sparse amount of material, and therefore a limited number of sections to be cut, a careful and thoughtful stepwise approach is necessary to ascertain a reliable diagnosis, or at least guide the clinician to the most likely diagnoses. With today's advanced and widely available technology with an abundance of markers to discriminate different tumours, the use of the term "undifferentiated" should be largely unnecessary. In the exceptional, and indeed exceedingly rare cases, when a classification is not possible, even after repeat biopsy, we suggest that the laryngeal neoplasm is better termed "unclassified malignant neoplasm" rather than "undifferentiated malignant neoplasm".
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Affiliation(s)
- H Hellquist
- CBMR, Centre for Biomedical Research, University of Algarve, Edificio 2, Ala Norte, University of Algarve, 8005-139, Faro, Portugal. .,Epigenetics and Human Disease Laboratory, Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal. .,Algarve Biomedical Centre, Campus Gambelas, University of Algarve, Faro, Portugal.
| | - J L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - A Cardesa
- Department of Anatomic Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - A Skalova
- Department of Pathology, Faculty of Medicine in Plzen, Charles University, Plzen, Czech Republic
| | - P J Slootweg
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Rinaldo
- University of Udine School of Medicine, Udine, Italy
| | - A Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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7
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D'Cruz AK, Vaish R, Vaidya A, Nixon IJ, Williams MD, Vander Poorten V, López F, Angelos P, Shaha AR, Khafif A, Skalova A, Rinaldo A, Hunt JL, Ferlito A. Molecular markers in well-differentiated thyroid cancer. Eur Arch Otorhinolaryngol 2018; 275:1375-1384. [PMID: 29626249 DOI: 10.1007/s00405-018-4944-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 03/19/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Thyroid nodules are of common occurrence in the general population. About a fourth of these nodules are indeterminate on aspiration cytology placing many a patient at risk of unwanted surgery. The purpose of this review is to discuss various molecular markers described to date and place their role in proper perspective. This review covers the fundamental role of the signaling pathways and genetic changes involved in thyroid carcinogenesis. The current literature on the prognostic significance of these markers is also described. METHODS PubMed was used to search relevant articles. The key terms "thyroid nodules", "thyroid cancer papillary", "carcinoma papillary follicular", "carcinoma papillary", "adenocarcinoma follicular" were searched in MeSH, and "molecular markers", "molecular testing", mutation, BRAF, RAS, RET/PTC, PAX 8, miRNA, NIFTP in title and abstract fields. Multiple combinations were done and a group of experts in the subject from the International Head and Neck Scientific Group extracted the relevant articles and formulated the review. RESULTS There has been considerable progress in the understanding of thyroid carcinogenesis and the emergence of numerous molecular markers in the recent years with potential to be used in the diagnostic algorithm of these nodules. However, their precise role in routine clinical practice continues to be a contentious issue. Majority of the studies in this context are retrospective and impact of these mutations is not independent of other prognostic factors making the interpretation difficult. CONCLUSION The prevalence of these mutations in thyroid nodule is high and it is a continuously evolving field. Clinicians should stay informed as recommendation on the use of these markers is expected to evolve.
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Affiliation(s)
- Anil K D'Cruz
- Head Neck Services, Tata Memorial Hospital, Parel, Mumbai, 400012, India.
| | - Richa Vaish
- Head Neck Services, Tata Memorial Hospital, Parel, Mumbai, 400012, India
| | - Abhishek Vaidya
- National Cancer Institute, Nagpur, India
- NKPSIMS, Nagpur, India
| | - Iain J Nixon
- Departments of Surgery and Otolaryngology, Head and Neck Surgery, Edinburgh University, Edinburgh, UK
| | - Michelle D Williams
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Vincent Vander Poorten
- Otorhinolaryngology-Head and Neck Surgery and Department of Oncology, Section Head and Neck Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, IUOPA, University of Oviedo, CIBERONC, Oviedo, Spain
| | - Peter Angelos
- Department of Surgery and Surgical Ethics, The University of Chicago Medicine, Chicago, IL, USA
| | - Ashok R Shaha
- Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Avi Khafif
- Head and Neck Surgery and Oncology Unit, A.R.M. Center for Advanced Otolaryngology Head and Neck Surgery, Assuta Medical Center, Tel Aviv, Israel
| | - Alena Skalova
- Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, Czech Republic
| | | | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
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8
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López F, Williams MD, Skálová A, Hellquist H, Suárez C, Nixon IJ, Rodrigo JP, Cardesa A, Strojan P, Quer M, Hunt JL, Rinaldo A, Ferlito A. How Phenotype Guides Management of the Most Common Malignant Salivary Neoplasms of the Larynx? Adv Ther 2017; 34:813-825. [PMID: 28224460 DOI: 10.1007/s12325-017-0494-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Indexed: 12/13/2022]
Abstract
Salivary gland carcinomas of the larynx are uncommon. Adenoid cystic carcinoma is the most prevalent type of salivary gland carcinoma in this region, although other histologies such as mucoepidermoid carcinoma and adenocarcinomas have been reported. These tumors may present with advanced-stage due to nonspecific symptoms and their relatively slow-growing nature. The index of suspicion for a non-squamous cell carcinoma entity should be high when a submucosal mass is present. An accurate diagnosis is mandatory due to the impact each biologic entity has on treatment and outcome. Data concerning treatment and outcome are scarce, but primary surgery with utmost focus on free surgical margins is the treatment of choice. The role of adjuvant radiotherapy has not been well defined, although there is an agreement that it should be considered in advanced-stage or high-grade disease. This review considers only the most common malignant salivary neoplasms of the larynx with a focus on clinical management of these tumors.
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Affiliation(s)
- Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
- Instituto Universitario de Oncología del Principado de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, University of Oviedo, Oviedo, Spain.
| | - Michelle D Williams
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alena Skálová
- Department of Pathology, Faculty of Medicine in Plzen, Charles University in Prague, Plzen, Czech Republic
| | - Henrik Hellquist
- Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal
| | - Carlos Suárez
- Instituto Universitario de Oncología del Principado de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, University of Oviedo, Oviedo, Spain
| | - Iain J Nixon
- Departments of Surgery and Otolaryngology, Head and Neck Surgery, Edinburgh University, Edinburgh, UK
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
- Instituto Universitario de Oncología del Principado de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, University of Oviedo, Oviedo, Spain
| | - Antonio Cardesa
- Department of Anatomic Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Miquel Quer
- Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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9
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López F, Williams MD, Cardesa A, Hunt JL, Strojan P, Rinaldo A, Nixon IJ, Rodrigo JP, Saba NF, Mendenhall WM, Quer M, Suárez C, Ferlito A. How phenotype guides management of non-conventional squamous cell carcinomas of the larynx? Eur Arch Otorhinolaryngol 2017; 274:2709-2726. [PMID: 28364287 DOI: 10.1007/s00405-017-4533-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 03/13/2017] [Indexed: 12/15/2022]
Abstract
Although the majority of laryngeal malignancies are the conventional squamous cell carcinomas (SCC), a wide variety of malignant epithelial tumors can affect the larynx. Current treatment guidelines are designed to guide clinicians in management of conventional laryngeal SCC. Less is known about the biological behavior and responsiveness to therapy and overall outcomes of other malignant epithelial lesions. Because a spectrum of disease biology is represented by these rare phenotypes, an understanding of the basic biology can help direct management to optimize clinical outcome in this group of patients. This review provides a critical analysis of literature relating to the diagnosis, management, and outcome of patients with non-conventional squamous malignant epithelial neoplasms of the larynx. Particular attention is paid to features which are at variance with the conventional SCC and how these impact on management of these rare tumors.
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Affiliation(s)
- Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Avenida de Roma s/n, 33011, Oviedo (Asturias), Spain. .,Instituto Universitario de Oncología del Principado de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, University of Oviedo, Oviedo, Spain.
| | - Michelle D Williams
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Antonio Cardesa
- Department of Anatomic Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | | | - Iain J Nixon
- Departments of Surgery and Otolaryngology, Head and Neck Surgery, Edinburgh University, Edinburgh, UK
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Avenida de Roma s/n, 33011, Oviedo (Asturias), Spain.,Instituto Universitario de Oncología del Principado de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, University of Oviedo, Oviedo, Spain
| | - Nabil F Saba
- Department of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | | | - Miquel Quer
- Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Carlos Suárez
- Instituto Universitario de Oncología del Principado de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, University of Oviedo, Oviedo, Spain
| | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
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10
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López F, Triantafyllou A, Snyderman CH, Hunt JL, Suárez C, Lund VJ, Strojan P, Saba NF, Nixon IJ, Devaney KO, Alobid I, Bernal-Sprekelsen M, Hanna EY, Rinaldo A, Ferlito A. Nasal juvenile angiofibroma: Current perspectives with emphasis on management. Head Neck 2017; 39:1033-1045. [PMID: 28199045 DOI: 10.1002/hed.24696] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/03/2016] [Accepted: 12/06/2016] [Indexed: 12/12/2022] Open
Abstract
Juvenile angiofibroma is an uncommon, benign, locally aggressive vascular tumor. It is found almost exclusively in young men. Common presenting symptoms include nasal obstruction and epistaxis. More advanced tumors may present with facial swelling and visual or neurological disturbances. The evaluation of patients with juvenile angiofibroma relies on diagnostic imaging. Preoperative biopsy is not recommended. The mainstay of treatment is resection combined with preoperative embolization. Endoscopic surgery is the approach of choice in early stages, whereas, in advanced stages, open or endoscopic approaches are feasible in expert hands. Postoperative radiotherapy (RT) or stereotactic radiosurgery seem valuable in long-term control of juvenile angiofibroma, particularly those that extend to anatomically critical areas unsuitable for complete resection. Chemotherapy and hormone therapy are ineffective. The purpose of the present review was to update current aspects of knowledge related to this rare and challenging disease. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1033-1045, 2017.
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Affiliation(s)
- Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.,Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, Spain
| | - Asterios Triantafyllou
- Pathology Department, Liverpool Clinical Laboratories, Liverpool, UK.,School of Dentistry, University of Liverpool, Liverpool, UK
| | - Carl H Snyderman
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Carlos Suárez
- Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, Spain
| | - Valerie J Lund
- Professorial Unit, Ear Institute, University College London, London, UK
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Nabil F Saba
- Department of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Iain J Nixon
- Departments of Surgery and Otolaryngology, Head and Neck Surgery, Edinburgh University, Edinburgh, UK
| | | | - Isam Alobid
- Department of Otolaryngology, Hospital Clinic, University of Barcelona Medical School, Barcelona, Spain
| | - Manuel Bernal-Sprekelsen
- Department of Otolaryngology, Hospital Clinic, University of Barcelona Medical School, Barcelona, Spain
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group
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11
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Hunt JL. Neoplasia and pre-neoplasia in head and neck mucosal sites. Pathology 2017. [DOI: 10.1016/j.pathol.2016.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Hunt JL. Pitfalls and perils in sinonasal pathology. Pathology 2017. [DOI: 10.1016/j.pathol.2016.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Hunt JL. Molecular testing in head and neck lesions. Pathology 2017. [DOI: 10.1016/j.pathol.2016.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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15
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Hunt JL. The modern challenges of encapsulated follicular thyroid tumours. Pathology 2017. [DOI: 10.1016/j.pathol.2016.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Triantafyllou A, Williams MD, Angelos P, Shah JP, Westra WH, Hunt JL, Devaney KO, Rinaldo A, Slootweg PJ, Gnepp DR, Silver C, Ferlito A. Incidental findings of thyroid tissue in cervical lymph nodes: old controversy not yet resolved? Eur Arch Otorhinolaryngol 2016; 273:2867-75. [PMID: 26459007 PMCID: PMC5525538 DOI: 10.1007/s00405-015-3786-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 09/14/2015] [Indexed: 12/21/2022]
Abstract
The clinical significance of papillary or follicular thyroid tissue incidentally discovered in cervical lymph nodes during pathological assessment of neck dissections for non-thyroid cancers of the upper aero-digestive tract is critically reviewed. Special emphasis is given to controversies over normal-looking, nodal, thyroid follicles. Arguments for and against the benign nature of these follicles are considered together with processes that could be involved in their formation. The admittedly limited evidence suggests that benign, thyroid follicular inclusions rarely occur in cervical lymph nodes. Histological criteria that could be helpful in recognizing the inclusions, which include assessing their extent in conjunction with the size of the node, are discussed. Finally, an algorithm based on collaboration between specialists, correlating histological findings with imaging and loco-regional control of the upper aero-digestive tract cancer, is suggested for the management of patients with incidentally discovered, nodal thyroid tissue.
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Affiliation(s)
- Asterios Triantafyllou
- Oral and Maxillofacial Pathology, School of Dentistry, University of Liverpool and Pathology Department, Liverpool Clinical Laboratories, Liverpool, UK
| | - Michelle D Williams
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Peter Angelos
- Department of Surgery, The University of Chicago Medicine, Chicago, IL, USA
| | - Jatin P Shah
- Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - William H Westra
- Departments of Pathology and Otolaryngology-Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | | | - Pieter J Slootweg
- Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Douglas R Gnepp
- University Pathologists, Providence, RI and Fall River, MA, USA
| | - Carl Silver
- Departments of Surgery and Otolaryngology-Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy.
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17
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Hunt JL, Gannon FH, Rosato EF, Siegelman ES, Tomaszewski JE, LiVolsi VA. A Non-epithelial Pseudosarcomatous Mural Nodule in a Mucinous Cystic Neoplasm of the Pancreas. Int J Surg Pathol 2016. [DOI: 10.1177/106689699700500107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A mucinous cystic neoplasm of indeterminate malignant potential was found to have a well-circumscribed, 3.1 cm pseudosarcomatous mural nodule, similar to those previously described in the ovary. The nodule contained reactive giant cells and intermediate to large-sized tumor cells with bizarre mitotic figures and nuclear atypia. The tumor cells were found to be of non-epithelial origin, based on multiple negative stains for cytokeratins and ultrastructural demonstration of osteoclastic and osteoblastic differentiation and absent desmosomes. This case report is the only description of a pseudosarcomatous mural nodule in a mucinous cystic neoplasm with non-epithelial origins.
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Affiliation(s)
| | - Francis H. Gannon
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA
| | - Ernest F. Rosato
- Departments of Surgery, University of Pennsylvania Medical Center, Philadelphia, PA
| | - Evan S. Siegelman
- Departments of Radiology, University of Pennsylvania Medical Center, Philadelphia, PA
| | | | - Virginia A. LiVolsi
- Departments of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA
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18
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Triantafyllou A, Thompson LDR, Devaney KO, Bell D, Hunt JL, Rinaldo A, Vander Poorten V, Ferlito A. Functional Histology of Salivary Gland Pleomorphic Adenoma: An Appraisal. Head Neck Pathol 2015; 9:387-404. [PMID: 25380577 PMCID: PMC4542802 DOI: 10.1007/s12105-014-0581-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 10/29/2014] [Indexed: 11/29/2022]
Abstract
The complex microstructure of salivary gland pleomorphic adenoma is examined in relation to function. Events related to secretion of macromolecules and absorption, responses to the altered microenvironment and controversies concerning epithelial-mesenchymal transition versus modified myoepithelial differentiation are explored. Their effects on tumor cell phenotypes and arrangements are emphasized. Heterotopic differentiation and attempts at organogenesis are also considered. The approach allows interpreting microstructure independently of histogenetic perceptions, envisaging the tumor cells as a continuum, endorsing luminal structures as the principal components, and defining pleomorphic adenoma as a benign epithelial tumour characterized by variable epithelial-mesenchymal transition, secretion/differentiation and metaplasia.
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Affiliation(s)
- Asterios Triantafyllou
- />Oral and Maxillofacial Pathology, School of Dentistry, University of Liverpool, Liverpool, UK
- />Cellular Pathology, University Hospital Aintree, Liverpool, UK
| | | | | | - Diana Bell
- />Department of Pathology, MD Anderson Cancer Center, Houston, TX USA
| | - Jennifer L. Hunt
- />Department of Pathology and Laboratory Medicine, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | | | - Vincent Vander Poorten
- />Otorhinolaryngology-Head and Neck Surgery, Department of Oncology, University Hospitals KU Leuven and Leuven Cancer Institute, Leuven, Belgium
- />European Salivary Gland Society, Geneva, Switzerland
| | - Alfio Ferlito
- />University of Udine School of Medicine, Udine, Italy
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19
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Bell D, Hanna EY, Weber RS, DeMonte F, Triantafyllou A, Lewis JS, Cardesa A, Slootweg PJ, Stenman G, Gnepp DR, Devaney KO, Rodrigo JP, Rinaldo A, Wenig BM, Westra WH, Bishop JA, Hellquist H, Hunt JL, Kusafuka K, Perez-Ordoñez B, Williams MD, Takes RP, Ferlito A. Neuroendocrine neoplasms of the sinonasal region. Head Neck 2015; 38 Suppl 1:E2259-66. [PMID: 26041714 DOI: 10.1002/hed.24152] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 05/18/2015] [Accepted: 05/31/2015] [Indexed: 11/06/2022] Open
Abstract
Neuroendocrine neoplasms of the sinonasal region, which are relatively uncommon but clinically very important, are reviewed here in the light of current knowledge. Using a definition for neuroendocrine based on phenotypic, histologic, immunohistochemical, and electron microscopic features rather than histogenetic criteria, sinonasal neuroendocrine carcinomas are examined with a particular emphasis on the small-cell and large-cell subtypes. This is followed by revisiting olfactory neuroblastoma because it is also a tumor that shows a neuroendocrine phenotype. Kadish clinical and Hyams histologic grading systems as prognosticators of olfactory neuroblastoma are also considered in detail. Finally, controversies regarding sinonasal undifferentiated carcinoma as a neuroendocrine tumor are discussed and a possible relationship with high-grade olfactory neuroblastoma is explored. Genetic events and current management of these tumors are also outlined. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2259-E2266, 2016.
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Affiliation(s)
- Diana Bell
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Randal S Weber
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Franco DeMonte
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Asterios Triantafyllou
- Oral and Maxillofacial Pathology, School of Dentistry, University of Liverpool and Cellular Pathology, University Hospital Aintree, Liverpool, United Kingdom
| | - James S Lewis
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Antonio Cardesa
- Department of Anatomic Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Pieter J Slootweg
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Göran Stenman
- Sahlgrenska Cancer Center, Department of Pathology, University of Gothenburg, Gothenburg, Sweden
| | - Douglas R Gnepp
- Head and Neck Pathology, University Pathologists, Warwick, Rhode Island and Fall River, Massachusetts
| | | | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
| | | | - Bruce M Wenig
- Department of Pathology, Beth Israel Medical Center, New York, New York
| | - William H Westra
- Departments of Pathology and Otolaryngology-Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Justin A Bishop
- Departments of Pathology and Otolaryngology-Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Henrik Hellquist
- Departamento de Ciências, Biomédicas e Medicina, Universidade do Algavre, Faro, Portugal
| | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Kimihide Kusafuka
- Pathology Division, Shizuoka Cancer Center Hospital and Research Institute, Shizuoka, Japan
| | - Bayardo Perez-Ordoñez
- Department of Pathology, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Michelle D Williams
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Robert P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group
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20
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López F, Rodrigo JP, Cardesa A, Triantafyllou A, Devaney KO, Mendenhall WM, Haigentz M, Strojan P, Pellitteri PK, Bradford CR, Shaha AR, Hunt JL, de Bree R, Takes RP, Rinaldo A, Ferlito A. Update on primary head and neck mucosal melanoma. Head Neck 2015; 38:147-55. [PMID: 25242350 DOI: 10.1002/hed.23872] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2014] [Indexed: 12/19/2022] Open
Abstract
Primary mucosal melanomas (PMMs) of the head and neck are uncommon malignancies that arise mainly in the nasal cavity and paranasal sinuses, followed by the oral cavity. The mainstay of treatment is radical surgical resection followed by adjuvant radiotherapy in selected patients with high-risk features. Multimodality therapy has not been well studied and is not standardized. Adjuvant radiotherapy seems to improve locoregional control but does not improve overall survival (OS). Elective neck dissection is advocated in patients with oral PMM. Systemic therapy should be considered only for patients with metastatic or unresectable locoregional disease. Despite improvements in the field of surgery, radiotherapy, and systemic therapy, patients with PMM still face a very unfavorable prognosis (5-year disease-free survival [DFS] <20%) with high rates of locoregional recurrence and distant metastasis. The present review aims to summarize the current state of knowledge on the molecular biology, pathological diagnosis, and management of this disease.
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Affiliation(s)
- Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | - Antonio Cardesa
- Department of Anatomic Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Asterios Triantafyllou
- Department of Oral Pathology, School of Dentistry, University of Liverpool, Liverpool, United Kingdom
| | | | | | - Missak Haigentz
- Department of Medicine, Division of Oncology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Phillip K Pellitteri
- Department of Otolaryngology-Head and Neck Surgery, Guthrie Health System, Sayre, Pennsylvania
| | - Carol R Bradford
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Ashok R Shaha
- Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Remco de Bree
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Robert P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Alfio Ferlito
- University of Udine School of Medicine, Udine, Italy
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21
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Coca-Pelaz A, Rodrigo JP, Bradley PJ, Vander Poorten V, Triantafyllou A, Hunt JL, Strojan P, Rinaldo A, Haigentz M, Takes RP, Mondin V, Teymoortash A, Thompson LDR, Ferlito A. Adenoid cystic carcinoma of the head and neck--An update. Oral Oncol 2015; 51:652-61. [PMID: 25943783 DOI: 10.1016/j.oraloncology.2015.04.005] [Citation(s) in RCA: 291] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 04/01/2015] [Accepted: 04/03/2015] [Indexed: 01/20/2023]
Abstract
This article provides an update on the current understanding of adenoid cystic carcinoma of the head and neck, including a review of its epidemiology, clinical behavior, pathology, molecular biology, diagnostic workup, treatment and prognosis. Adenoid cystic carcinoma is an uncommon salivary gland tumor that may arise in a wide variety of anatomical sites in the head and neck, often with an advanced stage at diagnosis. The clinical course is characterized by very late recurrences; consequently, clinical follow-up should extend at least >15 years. The optimal treatment is generally considered to be surgery with postoperative radiotherapy to optimize local disease control. Much effort has been invested into understanding the tumor's molecular biological processes, aiming to identify patients at high risk of recurrence, in hopes that they could benefit from other, still unproven treatment modalities such as chemotherapy or biological therapy.
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Affiliation(s)
- Andrés Coca-Pelaz
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Spain
| | - Patrick J Bradley
- Department of Otorhinolaryngology-Head and Neck Surgery, Nottingham University Hospitals, Queens Medical Centre Campus, Nottingham, UK; European Salivary Gland Society, Geneva, Switzerland
| | - Vincent Vander Poorten
- European Salivary Gland Society, Geneva, Switzerland; Otorhinolaryngology-Head and Neck Surgery and Department of Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | | | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | | | - Missak Haigentz
- Department of Medicine, Division of Oncology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Robert P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Vanni Mondin
- University of Udine School of Medicine, Udine, Italy
| | - Afshin Teymoortash
- Department of Otolaryngology-Head and Neck Surgery, University of Marburg, Marburg, Germany
| | - Lester D R Thompson
- Department of Pathology, Woodland Hills Medical Center, Woodland Hills, CA, USA
| | - Alfio Ferlito
- University of Udine School of Medicine, Udine, Italy.
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22
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Ferlito A, Coca-Pelaz A, Rodrigo JP, Triantafyllou A, Devaney KO, Hunt JL, Perez-Ordoñez B, Slootweg PJ, Bell D, Bishop JA, Rinaldo A. New tumor phenotypes reported in the larynx in the last decades: a critique. Am J Otolaryngol 2015; 36:494-7. [PMID: 25725968 DOI: 10.1016/j.amjoto.2015.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 02/03/2015] [Indexed: 12/28/2022]
Affiliation(s)
- Alfio Ferlito
- University of Udine School of Medicine, Udine, Italy.
| | - Andrés Coca-Pelaz
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | - Asterios Triantafyllou
- Pathology Department, Liverpool Clinical Laboratories and Oral & Maxillofacial Pathology, School of Dentistry, University of Liverpool, Liverpool, UK
| | | | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Bayardo Perez-Ordoñez
- Department of Pathology, Toronto General Hospital, University Health Network, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Pieter J Slootweg
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Diana Bell
- Department of Pathology, MD Anderson Cancer Center, Houston, TX
| | - Justin A Bishop
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD; Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD
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23
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Bishop JA, Thompson LDR, Cardesa A, Barnes L, Lewis JS, Triantafyllou A, Hellquist H, Stenman G, Hunt JL, Williams MD, Slootweg PJ, Devaney KO, Gnepp DR, Wenig BM, Rinaldo A, Ferlito A. Rhabdomyoblastic Differentiation in Head and Neck Malignancies Other Than Rhabdomyosarcoma. Head Neck Pathol 2015; 9:507-18. [PMID: 25757816 PMCID: PMC4651923 DOI: 10.1007/s12105-015-0624-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 03/05/2015] [Indexed: 12/21/2022]
Abstract
Rhabdomyosarcoma is a relatively common soft tissue sarcoma that frequently affects children and adolescents and may involve the head and neck. Rhabdomyosarcoma is defined by skeletal muscle differentiation which can be suggested by routine histology and confirmed by immunohistochemistry for the skeletal muscle-specific markers myogenin or myoD1. At the same time, it must be remembered that when it comes to head and neck malignancies, skeletal muscle differentiation is not limited to rhabdomyosarcoma. A lack of awareness of this phenomenon could lead to misdiagnosis and, subsequently, inappropriate therapeutic interventions. This review focuses on malignant neoplasms of the head and neck other than rhabdomyosarcoma that may exhibit rhabdomyoblastic differentiation, with an emphasis on strategies to resolve the diagnostic dilemmas these tumors may present. Axiomatically, no primary central nervous system tumors will be discussed.
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Affiliation(s)
- Justin A. Bishop
- />Departments of Pathology and Otolaryngology-Head and Neck Surgery, The Johns Hopkins University, 401 N. Broadway, Weinberg 2249, Baltimore, MD 21231 USA
| | | | - Antonio Cardesa
- />Department of Anatomic Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Leon Barnes
- />Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - James S. Lewis
- />Departments of Pathology and Immunology and Otolaryngology Head and Neck Surgery, Washington University in St. Louis, St. Louis, MO USA
| | | | - Henrik Hellquist
- />Departamento de Ciências, Biomédicas e Medicina, Universidade do Algarve, Faro, Portugal
| | - Goran Stenman
- />Sahlgrenska Cancer Center, Department of Pathology, University of Gothenburg, Gothenburg, Sweden
| | - Jennifer L. Hunt
- />Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Michelle D. Williams
- />Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Pieter J. Slootweg
- />Department of Pathology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | | | | | - Bruce M. Wenig
- />Department of Pathology, Beth Israel Medical Center, New York, NY USA
| | | | - Alfio Ferlito
- />Departments of Pathology and Otolaryngology-Head and Neck Surgery, The Johns Hopkins University, 401 N. Broadway, Weinberg 2249, Baltimore, MD 21231 USA
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Szyfter K, Wierzbicka M, Hunt JL, Rinaldo A, Rodrigo JP, Takes RP, Ferlito A. Frequent chromosomal aberrations and candidate genes in head and neck squamous cell carcinoma. Eur Arch Otorhinolaryngol 2014; 273:537-45. [PMID: 25355032 DOI: 10.1007/s00405-014-3339-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 10/14/2014] [Indexed: 12/21/2022]
Abstract
The knowledge of the biology of head and neck squamous cell carcinoma (HNSCC) has had relatively little impact on the improvement in oncologic outcome up to date. However, the identification of oncogenes and tumor suppressor genes (TSGs) involved in cancer progression contributes to the understanding of the molecular pathways involved in oncogenesis and could contribute to individual risk assessment and provide tools for improvement of treatment and targets for therapy based on the alterations in these pathways. The aim of this article is to review the chromosomal aberrations commonly found in HNSCC, to identify the genes in these chromosomal regions suggested to act as (candidate) oncogenes or TSGs, and to discuss the molecular mechanisms modulating their expression.
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Affiliation(s)
- Krzysztof Szyfter
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Malgorzata Wierzbicka
- Department of Otolaryngology and Laryngeal Oncology, K. Marcinkowski University of Medical Sciences, Poznan, Poland
| | - Jennifer L Hunt
- Department of Pathology and Laboratory Services, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | - Robert P Takes
- Department of Otolaryngology Head and Neck Surgery, Radboud University Medicine Center, Nijmegen, The Netherlands
| | - Alfio Ferlito
- University of Udine School of Medicine, Udine, Italy.
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25
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de Bree R, Takes RP, Castelijns JA, Medina JE, Stoeckli SJ, Mancuso AA, Hunt JL, Rodrigo JP, Triantafyllou A, Teymoortash A, Civantos FJ, Rinaldo A, Pitman KT, Hamoir M, Robbins KT, Silver CE, Hoekstra OS, Ferlito A. Advances in diagnostic modalities to detect occult lymph node metastases in head and neck squamous cell carcinoma. Head Neck 2014; 37:1829-39. [PMID: 24954811 DOI: 10.1002/hed.23814] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 05/02/2014] [Accepted: 06/18/2014] [Indexed: 12/19/2022] Open
Abstract
Regional metastasis is a prominent feature of head and neck squamous cell carcinoma (HNSCC) and is an important prognostic factor. The currently available imaging techniques for assessment of the neck have limitations in accuracy; thus, elective neck dissection has remained the usual choice of management of the clinically N0 neck (cN0) for tumors with significant (≥20%) incidence of occult regional metastasis. As a consequence, the majority of patients without regional metastasis will undergo unnecessary treatment. The purpose of this review was to discuss new developments in techniques that potentially improve the accuracy of the assessment of the neck in patients with HNSCC. Although imaging has improved in the last decades, a limitation common to all imaging techniques is a lack of sensitivity for small tumor deposits. Therefore, complementary to improvements in imaging techniques, developments in more invasive diagnostic procedures, such as sentinel node biopsy (SNB) will add to the accuracy of diagnostic algorithms for the staging of the neck.
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Affiliation(s)
- Remco de Bree
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Robert P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jonas A Castelijns
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Jesus E Medina
- Department of Otorhinolaryngology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Sandro J Stoeckli
- Department of Otorhinolaryngology-Head and Neck Surgery, Kantonsspital, St. Gallen, Switzerland
| | - Anthony A Mancuso
- Department of Radiology, University of Florida College of Medicine, Gainesville, Florida
| | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | | | - Afshin Teymoortash
- Department of Otolaryngology-Head and Neck Surgery, University of Marburg, Marburg, Germany
| | - Francisco J Civantos
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida
| | | | - Karen T Pitman
- Department of Surgery, Banner MD Anderson Cancer Center, Gilbert, Arizona
| | - Marc Hamoir
- Department of Head and Neck Surgery, Head and Neck Oncology Program, St. Luc University Hospital and Cancer Center, Brussels, Belgium
| | - K Thomas Robbins
- Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Carl E Silver
- Departments of Surgery and Otolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
| | - Otto S Hoekstra
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Alfio Ferlito
- University of Udine School of Medicine, Udine, Italy
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26
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Hunt JL. An introduction to molecular pathology of the head and neck. Arch Pathol Lab Med 2014; 138:730. [PMID: 24878012 DOI: 10.5858/arpa.2014-0060-ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Jennifer L Hunt
- From the Department of Pathology and Laboratory Services, University of Arkansas for Medical Sciences, Little Rock
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27
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de Bree E, Karatzanis A, Hunt JL, Strojan P, Rinaldo A, Takes RP, Ferlito A, de Bree R. Lipomatous tumours of the head and neck: a spectrum of biological behaviour. Eur Arch Otorhinolaryngol 2014; 272:1061-77. [DOI: 10.1007/s00405-014-3065-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 04/15/2014] [Indexed: 12/13/2022]
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28
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Naritoku WY, Alexander CB, Bennett BD, Black-Schaffer WS, Brissette MD, Grimes MM, Hoffman RD, Hunt JL, Iezzoni JC, Johnson R, Kozel J, Mendoza RM, Post MD, Powell SZ, Procop GW, Steinberg JJ, Thorsen LM, Nestler SP. The pathology milestones and the next accreditation system. Arch Pathol Lab Med 2014; 138:307-15. [PMID: 24576024 DOI: 10.5858/arpa.2013-0260-sa] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT In the late 1990s, the Accreditation Council for Graduate Medical Education developed the Outcomes Project and the 6 general competencies with the intent to improve the outcome of graduate medical education in the United States. The competencies were used as the basis for developing learning goals and objectives and tools to evaluate residents' performance. By the mid-2000s the stakeholders in resident education and the general public felt that the Outcomes Project had fallen short of expectations. OBJECTIVE To develop a new evaluation method to track trainee progress throughout residency using benchmarks called milestones. A change in leadership at the Accreditation Council for Graduate Medical Education brought a new vision for the accreditation of training programs and a radically different approach to the evaluation of residents. DATA SOURCES The Pathology Milestones Working Group reviewed examples of developing milestones in other specialties, the literature, and the Accreditation Council for Graduate Medical Education program requirements for pathology to develop pathology milestones. The pathology milestones are a set of objective descriptors for measuring progress in the development of competency in patient care, procedural skill sets, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. CONCLUSIONS The milestones provide a national standard for evaluation that will be used for the assessment of all residents in Accreditation Council for Graduate Medical Education-accredited pathology training programs.
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Affiliation(s)
- Wesley Y Naritoku
- From the Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles (Dr Naritoku); the Department of Pathology, University of Alabama Birmingham (Dr Alexander); the American Board of Pathology, Tampa, Florida (Dr Bennett and Johnson); the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston (Dr Black-Schaffer); the Hematopathology Division, Joint Pathology Center, Silver Springs, Maryland, and Washington, DC (Dr Brissette); the Department of Pathology, Virginia Commonwealth University Medical Center, Richmond (Dr Grimes); the Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Hoffman); the Department of Pathology, University of Arkansas for Medical Sciences, Little Rock (Dr Hunt); the Department of Pathology, University of Virginia Health System, Charlottesville (Dr Iezzoni); the Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha (Dr Kozel); the Department of Pathology, East Carolina University, Greenville, North Carolina (Dr Mendoza); the Department of Pathology, University of Colorado School of Medicine, Aurora (Dr Post); the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas (Dr Powell); the Department of Molecular Pathology, Cleveland Clinic Foundation, The Pathology and Laboratory Medicine Institute, Cleveland, Ohio (Dr Procop); the Department of Pathology, Albert Einstein College of Medicine, Bronx, New York (Dr Steinberg); and the Accreditation Council for Graduate Medical Education, Chicago, Illinois (Ms Thorsen and Dr Nestler)
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Volmar KE, Idowu MO, Hunt JL, Souers RJ, Meier FA, Nakhleh RE. Surgical Pathology Report Defects: A College of American Pathologists Q-Probes Study of 73 Institutions. Arch Pathol Lab Med 2014; 138:602-12. [DOI: 10.5858/arpa.2013-0099-cp] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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30
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de Bree E, Zoras O, Hunt JL, Takes RP, Suárez C, Mendenhall WM, Hinni ML, Rodrigo JP, Shaha AR, Rinaldo A, Ferlito A, de Bree R. Desmoid tumors of the head and neck: a therapeutic challenge. Head Neck 2014; 36:1517-26. [PMID: 24421052 DOI: 10.1002/hed.23496] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 06/22/2013] [Accepted: 09/09/2013] [Indexed: 12/23/2022] Open
Abstract
Desmoid tumor, or aggressive fibromatosis, is a rare, histologically benign, fibroblastic lesion that infrequently presents in the head and neck. Desmoid tumors often grow locally, invasively, and may, in rare instances, be fatal secondary to invasion into critical structures, such as airway or major vessels. The most common treatment is surgery, but desmoid tumors are characteristically associated with a high local recurrence rate after resection. Although the margin status seems to be of importance, operations that avoid function loss and esthetic disfigurement should be the primary goal. The efficacy of postoperative radiotherapy is controversial. Its potential benefit should be carefully balanced against possible radiation-induced adverse effects. Alternative treatment modalities, such as primary radiotherapy and medical treatment or a wait-and-see policy, may be preferable to mutilating surgery. Considering all the aforementioned, it seems obvious that desmoid tumors of the head and neck present a therapeutic challenge and require an individualized approach.
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Affiliation(s)
- Eelco de Bree
- Department of Surgical Oncology, Medical School of Crete University Hospital, Heraklion, Greece
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Abstract
The most common thyroid neoplasms are either follicular derived (papillary, follicular and Hürthle cell lesions) or C-cell derived (medullary carcinoma). The diagnosis of these tumors can usually be made at the histologic level, with immunohistochemical stains necessary in some circumstances. Specific molecular mutations have been described that can be diagnostically useful or explain, in part, their pathogenesis, including the well-known Ret/PTC and PPARgamma-PAX8 translocations, point mutations in the Ret, Ras and BRAF genes, and loss of heterozygosity of multiple different tumor suppressor genes. Some unusual tumors of the thyroid gland are more difficult to diagnose. In examining these lesions, the pathologist may use the hematoxylin and eosin-stained morphology, coupled with an analysis of the immunohistochemical staining profiles and possibly analysis of the underlying molecular mutational patterns. These less common thyroid tumors include tall cell and cribriform-morular variants of papillary carcinoma, hyalinizing trabecular tumor, mucoepidermoid and sclerosing mucoepidermoid carcinoma with eosinophilia, poorly differentiated (insular) carcinoma, and undifferentiated (anaplastic) carcinoma. The diagnostic features of these rare tumors, including the histology, immunohistochemical expression profiles and the known molecular mutational profiles of each, are reviewed.
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Affiliation(s)
- Jennifer L Hunt
- University of Pittsburgh Medical Center, Department of Pathology, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
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Lewis JS, Westra WH, Thompson LDR, Barnes L, Cardesa A, Hunt JL, Williams MD, Slootweg PJ, Triantafyllou A, Woolgar JA, Devaney KO, Rinaldo A, Ferlito A. The sinonasal tract: another potential "hot spot" for carcinomas with transcriptionally-active human papillomavirus. Head Neck Pathol 2013; 8:241-9. [PMID: 24338611 PMCID: PMC4126925 DOI: 10.1007/s12105-013-0514-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 12/03/2013] [Indexed: 11/30/2022]
Abstract
While high risk human papillomavirus (HPV) is well established as causative and clinically important for squamous cell carcinoma (SCC) of the oropharynx, its role in non-oropharyngeal head and neck SCC is much less clearly elucidated. In the sinonasal region, in particular, although it is a relatively uncommon site for SCC, as many as 20 % of SCC harbor transcriptionally-active high risk HPV. These tumors almost always have a nonkeratinizing morphology and may have a better prognosis. In addition, specific variants of SCC as well as other rare carcinoma types, when arising in the sinonasal tract, can harbor transcriptionally-active HPV. This article reviews the current literature on HPV in sinonasal carcinomas, attempts to more clearly demonstrate what tumors have it and how this relates to possible precursor lesions like inverted papilloma, and discusses the possible clinical ramifications of the presence of the virus.
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Affiliation(s)
- James S Lewis
- Departments of Pathology and Immunology and Otolaryngology Head and Neck Surgery, Division of Anatomic and Molecular Pathology, Washington University School of Medicine, St. Louis, MO, USA,
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Coca-Pelaz A, Rodrigo JP, Triantafyllou A, Hunt JL, Fernández-Miranda JC, Strojan P, de Bree R, Rinaldo A, Takes RP, Ferlito A. Chondrosarcomas of the head and neck. Eur Arch Otorhinolaryngol 2013; 271:2601-9. [PMID: 24213203 DOI: 10.1007/s00405-013-2807-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 10/30/2013] [Indexed: 12/30/2022]
Abstract
Chondrosarcoma represents approximately 11% of all primary malignant bone tumors. It is the second most common sarcoma arising in bone after osteosarcoma. Chondrosarcomas of the head and neck are rare and may involve the sinonasal tract, jaws, larynx or skull base. Depending on the anatomical location, the tumor can produce a variety of symptoms. Computed tomography and magnetic resonance imaging are the preferred imaging modalities. The histology of conventional chondrosarcoma is relatively straightforward; major challenges are the distinction between grade I chondrosarcomas and chondromas, and the differential diagnosis with chondroblastic osteosarcoma and chondroid chordoma. Surgery alone or followed by adjuvant radiotherapy is the treatment of choice. Radiotherapy alone has also been reported to be effective and can be considered if mutilating radical surgery is the only curative alternative. The 5-year survival for chondrosarcoma reaches 80%; distant metastases and/or local recurrences significantly worsen prognosis. The present review aims to summarize the current state of information about the biology, diagnosis and management of these rare tumors.
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Affiliation(s)
- Andrés Coca-Pelaz
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
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Ferlito A, Devaney KO, Hunt JL, Rinaldo A. Is the clinical course of laryngeal typical carcinoid tumor indolent? Eur Arch Otorhinolaryngol 2013; 271:1-2. [DOI: 10.1007/s00405-013-2686-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 08/29/2013] [Indexed: 10/26/2022]
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35
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Hunt JL, Barnes L, Lewis JS, Mahfouz ME, Slootweg PJ, Thompson LDR, Cardesa A, Devaney KO, Gnepp DR, Westra WH, Rodrigo JP, Woolgar JA, Rinaldo A, Triantafyllou A, Takes RP, Ferlito A. Molecular diagnostic alterations in squamous cell carcinoma of the head and neck and potential diagnostic applications. Eur Arch Otorhinolaryngol 2013; 271:211-23. [PMID: 23467835 DOI: 10.1007/s00405-013-2400-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 02/07/2013] [Indexed: 12/12/2022]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a common malignancy that continues to be difficult to treat and cure. In many organ systems and tumor types, there have been significant advances in the understanding of the molecular basis for tumorigenesis, disease progression and genetic implications for therapeutics. Although tumorigenesis pathways and the molecular etiologies of HNSCC have been extensively studied, there are still very few diagnostic clinical applications used in practice today. This review discusses current clinically applicable molecular markers, including viral detection of Epstein-Barr virus and human papillomavirus, and molecular targets that are used in diagnosis and management of HNSCC. The common oncogenes EGFR, RAS, CCND1, BRAF, and PIK3CA and tumor suppressor genes p53, CDKN2A and NOTCH are discussed for their associations with HNSCC. Discussion of markers with potential future applications is also included, with a focus on molecular alterations associated with targeted therapy resistance.
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Affiliation(s)
- Jennifer L Hunt
- Department of Pathology and Laboratory Services, College of Medicine, University of Arkansas for Medical Sciences, Arkansas, USA
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36
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Hunt JL. Practical Applications of Molecular Pathology. Surg Pathol Clin 2012; 5:ix-x. [PMID: 26838512 DOI: 10.1016/j.path.2012.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Jennifer L Hunt
- University of Arkansas for Medical Sciences, Mail Slot 517, 4301 W. Markham Street, Little Rock, AR 72205-7199, USA.
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Abstract
Presented here are the salivary gland tumors now recognized to have significant and highly prevalent translocations. These include both common and uncommon malignancies: mucoepidermoid carcinoma, adenoid cystic carcinoma, mammary analog secretory carcinoma, and clear cell carcinoma. These mutations have potential diagnostic applications, particularly in difficult and challenging variant morphologies are unusually challenging differential diagnoses. Practical applications of the molecular pathology of these tumors is discussed. The mutational assessment may also prove to have therapeutic importance, as targeted therapies may be generated for these tumors in the future.
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Affiliation(s)
- Jennifer L Hunt
- University of Arkansas for Medical Sciences, Mail Slot 517, 4301 West Markham Street, Little Rock, AR 72205-7199, USA.
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38
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Hinni ML, Ferlito A, Brandwein-Gensler MS, Takes RP, Silver CE, Westra WH, Seethala RR, Rodrigo JP, Corry J, Bradford CR, Hunt JL, Strojan P, Devaney KO, Gnepp DR, Hartl DM, Kowalski LP, Rinaldo A, Barnes L. Surgical margins in head and neck cancer: A contemporary review. Head Neck 2012; 35:1362-70. [DOI: 10.1002/hed.23110] [Citation(s) in RCA: 201] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2012] [Indexed: 11/10/2022] Open
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39
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Wu RI, Mark EJ, Hunt JL. Staining for acid-fast bacilli in surgical pathology: practice patterns and variations. Hum Pathol 2012; 43:1845-51. [PMID: 22542129 DOI: 10.1016/j.humpath.2012.01.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 01/12/2012] [Accepted: 01/13/2012] [Indexed: 11/16/2022]
Abstract
Analysis of acid-fast bacilli stains on sputum smears for the diagnosis of tuberculosis has a long history, but quality control for acid-fast bacilli in histologic sections is not as well established. In tissues, necrotizing granulomas are closely linked to positive cultures for mycobacteria. However, the practices of pathologists examining acid-fast bacilli in surgical specimens are not well described in the literature. This study characterizes practice patterns related to the histologic interpretation of acid-fast bacilli stains. A survey invitation was sent to 1299 pathologists including members of the Pulmonary Pathology Society and randomly selected fellows of the College of American Pathologists. Twenty-one questions inquired about demographics, ordering and interpreting acid-fast bacilli stains, reporting, and correlation. Of the 392 responses (30.2% response rate), 363 respondents review acid-fast bacilli stains on histologic sections. Approximately half of respondents practice in an academic setting, with the other half in community practice. Most respondents examine the entire acid-fast bacilli slide with the ×40 objective; approximately half confirm the organisms under oil immersion at ×100. There was considerable variation in when an acid-fast bacilli stain is ordered, as well as possible additional workup for negative cases, reporting of results, correlation with clinical and culture findings, and training. Many respondents reported never having been taught a general approach to acid-fast bacilli interpretation. There is substantial variation in practice patterns involving all aspects of ordering, histologic examination, and reporting of acid-fast bacilli stains. Future efforts to standardize the interpretation of acid-fast bacilli stains can potentially improve the diagnosis of mycobacterial disease.
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Affiliation(s)
- Roseann I Wu
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 20114, USA.
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40
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41
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Hunt JL. Molecular pathology for the anatomical pathologist: a case based discussion. Pathology 2012. [DOI: 10.1016/s0031-3025(16)32620-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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42
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Hunt JL. Thyrophobia: how to overcome your fear of thyroid follicular tumours. Pathology 2012. [DOI: 10.1016/s0031-3025(16)32619-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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García JJ, Hunt JL, Weinreb I, McHugh JB, Barnes EL, Cieply K, Dacic S, Seethala RR. Fluorescence in situ hybridization for detection of MAML2 rearrangements in oncocytic mucoepidermoid carcinomas: utility as a diagnostic test. Hum Pathol 2011; 42:2001-9. [DOI: 10.1016/j.humpath.2011.02.028] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Revised: 02/04/2011] [Accepted: 02/09/2011] [Indexed: 01/08/2023]
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Hunt JL. New applications for old assays and the importance of validation. Cancer Cytopathol 2011; 120:3-6. [DOI: 10.1002/cncy.20196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 08/08/2011] [Accepted: 08/13/2011] [Indexed: 11/10/2022]
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Abstract
CONTEXT Molecular testing in anatomic pathology is becoming standardized and can contribute valuable diagnostic, therapeutic, and prognostic information for the clinical management of patients. In head and neck pathology, recent advances in molecular testing have provided important targets in several different diagnostic areas, with particular emerging clinical applications in squamous and salivary gland pathology. In squamous mucosal-derived lesions, human papilloma virus has emerged as an important pathogenic etiology in a subset of oropharyngeal squamous cell carcinomas. Within the category of salivary gland tumors, 3 tumors have recently been recognized that contain oncogenic translocations. OBJECTIVE To describe the current state of information about the molecular alterations in squamous lesions and in salivary gland tumors of the head and neck. DATA SOURCES Published literature on squamous and salivary gland tumors of the head and neck. CONCLUSIONS The different approaches to identification of viral-associated tumors include assays using polymerase chain reaction, in situ hybridization, and immunohistochemistry. Most mucoepidermoid carcinomas harbor MECT1-MAML2 gene rearrangement. The MYB-NFIB translocations have recently been identified in adenoid cystic carcinomas. Finally, a newly described tumor of salivary gland, mammary analogue secretory carcinoma, harbors the ETV6-NTRK3 translocation. Although these translocations are just emerging as diagnostic targets, future roles may evolve as potential therapeutic targets.
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Affiliation(s)
- Jennifer L Hunt
- Department of Pathology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA.
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Bilodeau EA, Hoschar AP, Barnes EL, Hunt JL, Seethala RR. Clear cell carcinoma and clear cell odontogenic carcinoma: a comparative clinicopathologic and immunohistochemical study. Head Neck Pathol 2011; 5:101-7. [PMID: 21290202 PMCID: PMC3098331 DOI: 10.1007/s12105-011-0244-4] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Accepted: 01/20/2011] [Indexed: 01/24/2023]
Abstract
Clear cell carcinoma or hyalinizing clear cell carcinoma (CCC) and clear cell odontogenic carcinoma (CCOC) are rare, low-grade and typically indolent malignancies that can be diagnostically challenging. In this study the clinicopathologic, histologic, and immunohistochemical features of 17 CCCs and 12 CCOCs are examined. The differential diagnosis of clear cell malignancies in the head and neck is discussed. The relationship of CCCs and CCOCs to other clear cell tumors on the basis of their immunohistochemical staining patterns is postulated.
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Affiliation(s)
- Elizabeth A. Bilodeau
- Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, 3501 Terrace St, Pittsburgh, PA 15261 USA
| | - Aaron P. Hoschar
- Department of Pathology, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44106 USA
| | - E. Leon Barnes
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA USA
| | - Jennifer L. Hunt
- Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA USA
| | - Raja R. Seethala
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA USA
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Liu X, Jakubowski M, Hunt JL. KRAS gene mutation in colorectal cancer is correlated with increased proliferation and spontaneous apoptosis. Am J Clin Pathol 2011; 135:245-52. [PMID: 21228365 DOI: 10.1309/ajcp7fo2vaxivstp] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
KRAS mutation occurs in 30% to 50% of colorectal cancers (CRCs) and has been suggested to be associated with proliferation and decreased apoptosis. In this study, we analyzed KRAS in 198 CRCs and compared the clinicopathologic variables between KRAS-mutated and wild-type CRCs. Also, a subset of 90 and 66 CRCs from this cohort underwent microsatellite instability testing and histomorphologic evaluation, and the frequency of microsatellite instability-high (MSI-H) and histomorphologic variables were compared between KRAS-mutated and wild-type CRCs. Clinicopathologic features (age, sex, and tumor site, depth, size, grade, and metastasis) were not different between KRAS-mutated and wild-type CRCs. Compared with wild-type KRAS CRCs, KRAS-mutated CRCs had a lower frequency of MSI-H (15% vs 42%; P = .015), a higher chance of having brisk mitosis (77% vs 43%, P = .022) and apoptosis (77% vs 28%; P = .00012), and a greater mean of mitotic figures (P = .0002) and apoptotic cells (P = .0008). KRAS mutation was associated with higher tumor cell turnover.
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Affiliation(s)
- Xiuli Liu
- Department of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, OH
| | - Maureen Jakubowski
- Department of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, OH
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Hafezi S, Seethala RR, Stelow EB, Mills SE, Leong IT, MacDuff E, Hunt JL, Perez-Ordoñez B, Weinreb I. Ewing's family of tumors of the sinonasal tract and maxillary bone. Head Neck Pathol 2010; 5:8-16. [PMID: 21107767 PMCID: PMC3037459 DOI: 10.1007/s12105-010-0227-x] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Accepted: 11/10/2010] [Indexed: 10/18/2022]
Abstract
The Ewing's family of tumors (EFT) are malignant neoplasms affecting children and young adults. Most cases arise in the long bones or the pelvis. Primary EFT of head and neck is uncommon and primary sinonasal EFT is even rarer. Previous studies have not focused on the sinonasal region specifically, and the published literature on sinonasal EFT consists of sporadic case reports. Fourteen cases of sinonasal EFT were available and had H&Es for review and immunohistochemical stains for CD99, S100, keratins, synaptophysin and desmin. FISH or RT-PCR was performed for EWSR1 abnormalities on 8 cases. The 14 identified patients included 5 males and 9 females, ranging from 7-70 years of age (mean 32.4 years). Tumors involved nasal cavity (5), sinuses (5) or both (4). Five patients had dural, orbital or brain involvement. The majority involved bone radiologically and/or microscopically. All cases were composed of small cells with variable cytoplasmic clearing. Focal or prominent nesting was noted in most cases. All cases were positive for CD99. Keratins (AE1/3 and/or CAM5.2), S100 and synaptophysin were positive in 4, 3 and 5 cases, respectively. All cases were negative for desmin. The 8 cases tested by FISH or RT-PCR were positive for EWSR1 abnormalities. Follow-up in 8 patients ranged from 1-168 months (average 11.3 m) showing 1 death due to metastatic disease, 1 death due to local disease, 1 patient alive with metastases and 5 patients disease-free at last follow-up. Interestingly, however, an analysis of the literature suggests a better prognosis for sinonasal EFT than EFT overall.
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Affiliation(s)
- Sara Hafezi
- Department of Pathology, University Health Network, Toronto, ON Canada ,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Raja R. Seethala
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA USA
| | - Edward B. Stelow
- Department of Pathology, University of Virginia, Charlottesville, VA USA
| | - Stacey E. Mills
- Department of Pathology, University of Virginia, Charlottesville, VA USA
| | - Iona T. Leong
- Departments of Pathology and Dentistry, Mount Sinai Hospital, Toronto, ON Canada
| | | | - Jennifer L. Hunt
- Department of Pathology, Massachusetts General Hospital, Boston, MA USA
| | - Bayardo Perez-Ordoñez
- Department of Pathology, University Health Network, Toronto, ON Canada ,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Ilan Weinreb
- Department of Pathology, University Health Network, Toronto, ON Canada ,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
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Malik SM, Nevin DT, Cohen S, Hunt JL, Palazzo JP. Assessment of immunohistochemistry for p16INK4 and high-risk HPV DNA by in situ hybridization in esophageal squamous cell carcinoma. Int J Surg Pathol 2010; 19:31-4. [PMID: 21087981 DOI: 10.1177/1066896910382005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The role of high-risk human papillomavirus (HPV) in the pathogenesis of esophageal squamous cell carcinoma (ESCC) remains unclear. p16(INK4) is used as a surrogate marker to detect HPV-related tumors but has had discrepant results in ESCC. In this study, 32 cases of ESCC were examined to determine the relationship between p16(INK4) expression and high-risk HPV. All the tumors were stained by immunohistochemistry for p16(INK4). Tumors having p16(INK4) nuclear and/or nuclear and cytoplasmic expression were considered positive. Tumors positive for p16(INK4) expression were tested for high-risk HPV by in situ hybridization (ISH). In all, 20 cases of ESCC (63%) showed only cytoplasmic staining for p16(INK4), and 11 cases (34%) showed both cytoplasmic and nuclear staining for p16(INK4); 4 cases (13%) showed no staining for p16(INK4). None of the p16(INK4) -positive cases were positive for high-risk HPV by ISH. These results indicate that p16(INK4) expression in ESCC does not correlate with the presence of high-risk HPV DNA by ISH. High-risk HPV does not seem to play a major role in the carcinogenesis of ESCC in low-risk areas.
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Affiliation(s)
- Sajjad M Malik
- Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA
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Weinreb I, Simpson RH, Skálová A, Perez-Ordoñez B, Dardick I, Chetty R, Hunt JL. Ductal adenomas of salivary gland showing features of striated duct differentiation (‘striated duct adenoma’): a report of six cases. Histopathology 2010; 57:707-15. [DOI: 10.1111/j.1365-2559.2010.03682.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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