Lymphoepithelial-like Carcinoma of the Oropharynx
- 1 June 2010
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in The American Journal of Surgical Pathology
- Vol. 34 (6), 800-805
- https://doi.org/10.1097/pas.0b013e3181d9ba21
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.This publication has 23 references indexed in Scilit:
- Head and neck squamous cell cancer and the human papillomavirus: Summary of a National Cancer Institute State of the Science Meeting, November 9–10, 2008, Washington, D.C.Head & Neck, 2009
- Does Epstein-Barr Virus Play a Role in Lymphoepithelioma-like Carcinoma of the Uterine Cervix?International Journal of Gynecological Pathology, 2009
- Improved Survival of Patients With Human Papillomavirus-Positive Head and Neck Squamous Cell Carcinoma in a Prospective Clinical TrialJNCI Journal of the National Cancer Institute, 2008
- Incidence Trends for Human Papillomavirus–Related and –Unrelated Oral Squamous Cell Carcinomas in the United StatesJournal of Clinical Oncology, 2008
- Differential expression of Epstein-Barr virus-encoded RNA and several tumor-related genes in various types of nasopharyngeal epithelial lesions and nasopharyngeal carcinoma using tissue microarray analysisHuman Pathology, 2006
- Human papillomavirus (HPV)-related oropharyngeal nonkeratinizing squamous cell carcinoma: Characterization of a distinct phenotypeOral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2006
- Tissue Distribution of Human Papillomavirus 16 DNA Integration in Patients with Tonsillar CarcinomaClinical Cancer Research, 2005
- Human papillomavirus-associated head and neck cancer is a distinct epidemiologic, clinical, and molecular entitySeminars in Oncology, 2004
- Evidence for a Causal Association Between Human Papillomavirus and a Subset of Head and Neck CancersJNCI Journal of the National Cancer Institute, 2000
- Lymphoepithelioma of the OropharynxOtolaryngology -- Head and Neck Surgery, 1989