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Diagnostically challenging lesions in head and neck pathology
1Department of Endocrine and Otorhinolaryngic-Head and Neck Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
Summary
Diagnosing challenging head and neck lesions requires careful clinical correlation. This review covers contact ulcers, spindle squamous cell carcinoma, verrucous carcinoma, sinonasal lymphoma, and cystic squamous cell carcinoma for accurate patient management.
Area of Science:
- Head and Neck Pathology
- Oncology
- Diagnostic Challenges
Background:
- Head and neck lesions present diagnostic challenges.
- Accurate diagnosis is crucial for appropriate clinical management.
Purpose of the Study:
- To review diagnostically challenging head and neck lesions.
- To highlight key clinical and histomorphologic features for accurate diagnosis.
Main Methods:
- Review of clinical parameters and histomorphologic features of various head and neck lesions.
- Emphasis on ancillary studies and clinical work-up for definitive diagnosis.
Main Results:
- Contact ulcers are associated with vocal abuse, post-intubation, and reflux.
- Spindle squamous cell carcinoma requires confirmation of epithelial origin.
- Verrucous carcinoma diagnosis relies on clinical history and specific histomorphology.
- Angiocentric T/NK-cell lymphoma presents as midline destructive disease.
- Cystic squamous cell carcinoma in the neck is typically metastatic from Waldeyer's ring.
Conclusions:
- Accurate diagnosis of head and neck lesions relies on integrating clinical presentation with histomorphologic findings.
- Thorough clinical work-up, including imaging and biopsies, is essential for optimal patient management and prognosis.