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Lymphoepithelial-like carcinoma of the oropharynx: a morphologic variant of HPV-related head and neck carcinoma.
Am J Surg Pathol. 2010 Jun; 34(6):800-5.AJ

Abstract

Human papillomavirus-associated squamous cell cancer of the head and neck (HPV-HNSCC) represents an important subgroup of head and neck cancer that is characterized by distinct epidemiologic, clinical, and pathologic features including a relatively constant microscopic appearance. For those cancers that deviate from the morphologic prototype, an association with HPV may not be recognized and accurate tumor classification may not be achieved. We have identified 22 cases of HPV-HNSCC with well-developed lymphoepithelial features including tumor cells with syncytial cytoplasm, vesicular nuclei, and large central nucleoli dispersed in an inflammatory background as cell clusters or single cells. The pattern closely resembles Epstein-Barr virus (EBV)-induced undifferentiated carcinoma of the nasopharynx. Indeed, 3 of the carcinomas presenting as lymph node metastases were originally misdiagnosed as metastatic nasopharyngeal carcinoma. Unlike nasopharyngeal carcinoma, the cases were of oropharyngeal origin, p16 positive by immunohistochemistry (22 of 22, 100%), HPV-16 positive by in-situ hybridization (19 of 22, 86%), and EBV negative by in-situ hybridization (21 of 21, 100%). Like conventional HPV-related HNSCC, the cases tended to occur in patients below 60 years of age (77%), men (73%), and nonsmokers (59%). For carcinomas of the head and neck that exhibit lymphoepithelial features, one cannot assume an EBV-driven process by morphology alone. HPV testing has disclosed a previously unrecognized morphologic variant of HPV-HNSCC that is microscopically indistinguishable from EBV-related carcinoma. For lymphoepithelial carcinomas presenting as cervical lymph node metastases, testing for HPV and EBV is mandatory.

Authors+Show Affiliations

Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD 21231-2410, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20421782

Citation

Singhi, Aatur D., et al. "Lymphoepithelial-like Carcinoma of the Oropharynx: a Morphologic Variant of HPV-related Head and Neck Carcinoma." The American Journal of Surgical Pathology, vol. 34, no. 6, 2010, pp. 800-5.
Singhi AD, Stelow EB, Mills SE, et al. Lymphoepithelial-like carcinoma of the oropharynx: a morphologic variant of HPV-related head and neck carcinoma. Am J Surg Pathol. 2010;34(6):800-5.
Singhi, A. D., Stelow, E. B., Mills, S. E., & Westra, W. H. (2010). Lymphoepithelial-like carcinoma of the oropharynx: a morphologic variant of HPV-related head and neck carcinoma. The American Journal of Surgical Pathology, 34(6), 800-5. https://doi.org/10.1097/PAS.0b013e3181d9ba21
Singhi AD, et al. Lymphoepithelial-like Carcinoma of the Oropharynx: a Morphologic Variant of HPV-related Head and Neck Carcinoma. Am J Surg Pathol. 2010;34(6):800-5. PubMed PMID: 20421782.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lymphoepithelial-like carcinoma of the oropharynx: a morphologic variant of HPV-related head and neck carcinoma. AU - Singhi,Aatur D, AU - Stelow,Edward B, AU - Mills,Stacey E, AU - Westra,William H, PY - 2010/4/28/entrez PY - 2010/4/28/pubmed PY - 2010/6/16/medline SP - 800 EP - 5 JF - The American journal of surgical pathology JO - Am. J. Surg. Pathol. VL - 34 IS - 6 N2 - Human papillomavirus-associated squamous cell cancer of the head and neck (HPV-HNSCC) represents an important subgroup of head and neck cancer that is characterized by distinct epidemiologic, clinical, and pathologic features including a relatively constant microscopic appearance. For those cancers that deviate from the morphologic prototype, an association with HPV may not be recognized and accurate tumor classification may not be achieved. We have identified 22 cases of HPV-HNSCC with well-developed lymphoepithelial features including tumor cells with syncytial cytoplasm, vesicular nuclei, and large central nucleoli dispersed in an inflammatory background as cell clusters or single cells. The pattern closely resembles Epstein-Barr virus (EBV)-induced undifferentiated carcinoma of the nasopharynx. Indeed, 3 of the carcinomas presenting as lymph node metastases were originally misdiagnosed as metastatic nasopharyngeal carcinoma. Unlike nasopharyngeal carcinoma, the cases were of oropharyngeal origin, p16 positive by immunohistochemistry (22 of 22, 100%), HPV-16 positive by in-situ hybridization (19 of 22, 86%), and EBV negative by in-situ hybridization (21 of 21, 100%). Like conventional HPV-related HNSCC, the cases tended to occur in patients below 60 years of age (77%), men (73%), and nonsmokers (59%). For carcinomas of the head and neck that exhibit lymphoepithelial features, one cannot assume an EBV-driven process by morphology alone. HPV testing has disclosed a previously unrecognized morphologic variant of HPV-HNSCC that is microscopically indistinguishable from EBV-related carcinoma. For lymphoepithelial carcinomas presenting as cervical lymph node metastases, testing for HPV and EBV is mandatory. SN - 1532-0979 UR - https://www.unboundmedicine.com/medline/citation/20421782/Lymphoepithelial_like_carcinoma_of_the_oropharynx:_a_morphologic_variant_of_HPV_related_head_and_neck_carcinoma_ L2 - http://dx.doi.org/10.1097/PAS.0b013e3181d9ba21 DB - PRIME DP - Unbound Medicine ER -