Head & Neck Pathology最新文献

{"title":"Laryngeal Coccidioidomycosis Mimicking Squamous Cell Carcinoma.","authors":"Chuying Su, James S Lewis","doi":"10.1007/s12105-025-01769-z","DOIUrl":"10.1007/s12105-025-01769-z","url":null,"abstract":"<p><p>Coccidioidomycosis is a rare fungal infection that can closely mimic squamous cell carcinoma (SCC) clinically and radiologically when presenting in the larynx, leading to potential misdiagnosis. This case highlights the importance of considering fungal infections in the differential diagnosis of laryngeal lesions, particularly in endemic regions.</p>","PeriodicalId":47972,"journal":{"name":"Head & Neck Pathology","volume":"19 1","pages":"29"},"PeriodicalIF":3.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Langerhans Cell Histiocytosis and Other Histiocytic Lesions.","authors":"Reed A McKinney, Guanghua Wang","doi":"10.1007/s12105-025-01766-2","DOIUrl":"10.1007/s12105-025-01766-2","url":null,"abstract":"<p><strong>Background: </strong>Histiocytoses, including Langerhans cell histiocytosis (LCH), comprise a diverse group of histiocytic disorders characterized by the abnormal accumulation and proliferation of histiocytes in various tissues or organs throughout the body, ranging from benign, self-limited conditions to aggressive malignancies and systemic inflammatory syndromes. These lesions present unique diagnostic challenges due to their broad spectrum of clinical presentations, overlapping histopathological and immunophenotypical features, and genetic complexity.</p><p><strong>Methods: </strong>This review analyzes major histiocytic lesions, focusing on their epidemiology, clinical presentations, histologic and immunophenotypic features, and genetic characteristics to facilitate accurate diagnosis and differentiation among these histiocytoses.</p><p><strong>Results: </strong>LCH, a well-recognized lesion, can affect various organ systems and necessitates differentiation from other types of histiocytoses such as Erdheim-Chester disease (ECD), Rosai-Dorfman-Destombes disease (RDD), and cutaneous and mucocutaneous non-Langerhans cell histiocytoses. Some histiocytic lesions, such as histiocytic sarcoma, are inherently malignant, while others, like hemophagocytic lymphohistiocytosis (HLH), manifest as severe, potentially life-threatening systemic inflammatory syndromes. Recent molecular genetic studies revealed recurrent genetic alterations in the MAPK pathway, such as BRAF V600E and MAP2K1 in LCH and ECD, and KRAS, NRAS, and MAP2K1 mutations in a subset of RDD. Malignant histiocytoses frequently show alterations in tumor suppressor genes like TP53 and CDKN2A.</p><p><strong>Conclusion: </strong>Precise classification of histiocytic lesions relies on a comprehensive diagnostic approach that integrates clinical, histologic, immunophenotypic, and genetic data. Recent genetic advances shed light on these conditions' unique but occasionally overlapping pathogenic mechanisms. Molecular genetics advancements continue to refine diagnostic accuracy and present new therapeutic targets, especially for aggressive or treatment-resistant cases.</p>","PeriodicalId":47972,"journal":{"name":"Head & Neck Pathology","volume":"19 1","pages":"26"},"PeriodicalIF":3.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermatologic Lesions with Eosinophilia in the Head and Neck.","authors":"David T Danielson, Ian Lagerstrom, Zachary Wary, Aaron Auerbach, David S Cassarino","doi":"10.1007/s12105-025-01757-3","DOIUrl":"10.1007/s12105-025-01757-3","url":null,"abstract":"<p><strong>Background: </strong>Dermatologic lesions with notable eosinophilic infiltration of the head and neck region represent a diverse group of conditions, ranging from benign to malignant proliferations.</p><p><strong>Methods: </strong>We performed a comprehensive literature review focusing on head and neck dermatologic conditions that commonly present with a prominent eosinophilic infiltrate.</p><p><strong>Results: </strong>This review provides an overview of common entities showing prominent associated eosinophilic inflammatory infiltrates in this region, including epithelioid hemangioma, eosinophilic cellulitis (Wells syndrome), eosinophilic folliculitis, eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome), granuloma faciale, and Langerhans cell histiocytosis (LCH).</p><p><strong>Conclusion: </strong>Eosinophils play a key role in the pathogenesis of these disorders, although the exact mechanisms remain poorly understood. Accurate diagnosis is crucial for differentiating these conditions, as they can share similar histologic features. This review aims to enhance understanding of these eosinophilic dermatologic conditions, improving diagnostic accuracy and treatment strategies.</p>","PeriodicalId":47972,"journal":{"name":"Head & Neck Pathology","volume":"19 1","pages":"27"},"PeriodicalIF":3.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eosinophils and the Head and Neck.","authors":"Henok Eskinder, Yang Zhang","doi":"10.1007/s12105-025-01765-3","DOIUrl":"10.1007/s12105-025-01765-3","url":null,"abstract":"<p><p>Tissue eosinophilia is a common finding during histopathologic evaluation and recognizing its presence oftentimes aids pathologists in arriving at the correct diagnosis. The head and neck region is an anatomic location where an abundance of eosinophil-rich disorders occur. In this review, we seek to provide an overview of eosinophil morphology, production, regulation, lifecycle, recruitment, function, and mediators. We will also summarize the most commonly diagnosed eosinophil-rich disorders, both non-neoplastic and neoplastic, occurring in the head and neck.</p>","PeriodicalId":47972,"journal":{"name":"Head & Neck Pathology","volume":"19 1","pages":"24"},"PeriodicalIF":3.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cemento-Osseous Dysplasia in a Female Bronze Age Skeleton (North Caucasus).","authors":"Julia Gresky, Melina Frotscher, Sophia Thiem, Alexander Stoessel, Alexey Kalmykov, Natalia Berezina","doi":"10.1007/s12105-025-01767-1","DOIUrl":"10.1007/s12105-025-01767-1","url":null,"abstract":"<p><strong>Purpose: </strong>The earliest known case of cemento-osseous dysplasia could be detected in a Bronze Age skeleton, dating back 4500 years ago in the region of the North Caucasus. Although the soft tissue was missing, sufficient diagnosis could be achieved by using different methods that prove the existence of fibro-osseous processes already in prehistory. Skeletal remains provide a direct view of such changes which cannot be obtained from a living patient without compromising.</p><p><strong>Methods: </strong>A skeleton of a 30-40-year-old female individual from the burial mound of Budyonnovsk 10 (including 19 individuals) in Southern Russia was investigated using macroscopic, radiographic, and microscopic methods.</p><p><strong>Results: </strong>In the mandible, destruction of the labial wall of the alveoli 32 and 31 is already visible macroscopically. At the base of the lesion, the original bone is replaced by fine porous bone including small dense particles: plain radiography and computed tomography evidence localized processes to the periapical areas of all lower incisors. The lesions are mainly radiolucent, only the particles in alveolus 32 have a radiopaque appearance. Microscopy shows woven bone as filling of the lesions and additional hypocellular materials in alveolus 32, which can best be explained as cementum-like structures.</p><p><strong>Conclusions: </strong>The lesion´s location in the periapical areas of the lower incisors, the woven bone, and cementum-like structures fit the diagnosis of periapical cemento-osseous dysplasia. The presence of a second individual with focal cemento-osseous dysplasia in this burial mound is an interesting co-occurrence that requires further genetic analysis.</p><p><strong>Limitations: </strong>The diagnosis is solely based on the skeletal remains, soft tissue components are missing.</p><p><strong>Suggestions for further research: </strong>Genetic analyses are planned to detect the underlying mutation for the two individuals.</p>","PeriodicalId":47972,"journal":{"name":"Head & Neck Pathology","volume":"19 1","pages":"28"},"PeriodicalIF":3.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of an Assay to Quantify Plasma Circulating Tumor Human Papillomavirus DNA for 13 High-Risk Types that Cause 98% of HPV-Positive Cancers.","authors":"Michael T Wotman, Weihong Xiao, Robyn R Du, Bo Jiang, Keiko Akagi, Suyu Liu, Maura L Gillison","doi":"10.1007/s12105-025-01752-8","DOIUrl":"10.1007/s12105-025-01752-8","url":null,"abstract":"<p><strong>Purpose: </strong>Plasma circulating tumor HPV DNA (ctHPVDNA) persistence after curative-intent treatment may identify patients with HPV-positive cancers at risk for recurrence. Technical validation is required for use as an integral biomarker in a prospective clinical trial.</p><p><strong>Methods: </strong>Development and analytical validation of a digital droplet PCR assay for detection and quantification of 13 high-risk HPV types (i.e., Cell-Free 13) was performed with oligonucleotides/plasmids encoding type-specific E6/E7 coding regions. Clinical performance, determinants of detection/quantification, and associations of pre-treatment ctHPVDNA with progression-free survival (PFS) were also evaluated in a prospective cohort of 272 head and neck cancer patients.</p><p><strong>Results: </strong>Limit of detection, limit of quantification, and linear range of quantification were 5, 16 and 16-200,000 virus copies for all 13 high-risk HPV types. No cross-reactivity was detected across all 13 HPV types. At 10,000 copies, inter-assay coefficients of variation ranged from 0.3 to 4.6%. Multiplexing, DNA purification method, input plasma volume, total input cell-free (< 1800 ng) or genomic (< 700 ng) DNA did not affect HPV detection or quantification. The assay had a sensitivity of 91.7% (95%CI 87.3-94.9%) and specificity of 97.7% (95%CI 87.7-99.9%) for ctHPVDNA detection in the setting of newly diagnosed HPV-positive oropharyngeal cancer. Tumor and nodal stage categories, tumor viral load (ρ = 0.41, p < 0.05), and HPV integration status were associated with ctHPVDNA quantitative level. Pre-treatment ctHPVDNA greater than the median (231 copies/ml) was associated with worse PFS (HR = 2.14, 95%CI 1.16-3.97, p = 0.0156) in univariate analysis. However, this was no longer significant after adjustment for clinical covariates (HR_adj = 1.81, 95%CI 0.97-3.37, p = 0.0635).</p><p><strong>Conclusion: </strong>Cell-Free 13 demonstrated excellent analytical performance and clinical sensitivity/specificity in HPV-positive oropharyngeal cancer. Pre-treatment ctHPVDNA may be associated with oncologic outcomes.</p>","PeriodicalId":47972,"journal":{"name":"Head & Neck Pathology","volume":"19 1","pages":"25"},"PeriodicalIF":3.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reevaluating Histopathologic and Molecular Insights in Ameloblastoma Management: A Call for Methodological Refinement.","authors":"Carlos M Ardila, Pradeep K Yadalam","doi":"10.1007/s12105-025-01764-4","DOIUrl":"10.1007/s12105-025-01764-4","url":null,"abstract":"","PeriodicalId":47972,"journal":{"name":"Head & Neck Pathology","volume":"19 1","pages":"23"},"PeriodicalIF":3.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological and Immunohistochemical Risk Predictors for Ameloblastoma Recurrence.","authors":"Hévila de Figueiredo Pires, Glória Maria de França, Hannah Gil de Farias Morais, Weslay Rodrigues da Silva, Roseana de Almeida Freitas, Hébel Cavalcanti Galvão","doi":"10.1007/s12105-024-01743-1","DOIUrl":"10.1007/s12105-024-01743-1","url":null,"abstract":"<p><strong>Purpose: </strong>Measure associations between clinicopathological and immunohistochemical human Mut-L homologue 1 (hMLH1) gene, and human Mut-L homologue 2 (hMSH2) genes, variables in recurrent AMBs.</p><p><strong>Methods: </strong>This study consisted of a research retrospective, observational case-control study consisting of 22 cases of recurrent AMB and 22 non-recurrent cases. Cases of AMB with more than one year of follow-up were included in the study. Quantitative immunohistochemical analysis was performed considering the cellular location (nuclear) of the proteins studied. The McNemar test was used to compare variables between primary and recurrent AMBs. Recurrence-free survival was analyzed by the Kaplan-Meier method and survival functions were compared according to the variables using the log-rank test.</p><p><strong>Results: </strong>The posterior mandible was the most affected site in the recurrent (n = 18, 81.8%) and non-recurrent groups (n = 16, 72.8%). Recurrence-free survival was 50.0 (34.5-63.6) months. The following factors were significantly associated with AMB recurrence: presence of cortical bone expansion (p = 0.01), absence of bone reconstruction (p = 0.02), conservative treatment (p = 0.02), loss of hMSH2 (p = 0.01) and hMLH1 (p = 0.04) immunoexpression, and strong Ki-67 immunoexpression (p = 0.03). The risk factors for AMB recurrence were anatomical location (OR = 3.31), locularity (OR = 1.07), cortical expansion (OR = 6.17), cortical perforation (OR = 2.10), bone resorption (OR = 1.52), tooth impaction (OR = 1.86), jaw reconstruction (OR = 6.92), and immunoexpression of hMSH2 (OR = 10.0) and hMLH1 (OR = 4.50).</p><p><strong>Conclusion: </strong>Radiographic appearance, treatment modality, and immunoexpression of mismatch repair proteins can be used as predictors of AMB recurrence.</p>","PeriodicalId":47972,"journal":{"name":"Head & Neck Pathology","volume":"19 1","pages":"22"},"PeriodicalIF":3.2,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Consensus Recommendations of Diagnostic Criteria and Terminologies for Extranodal Extension in Head and Neck Squamous Cell Carcinoma: An HN CLEAR Initiative (Update 1).","authors":"Ruta Gupta, Timothy Fielder, Munita Bal, Simion I Chiosea, Jane E Dahlstrom, Aanchal Kakkar, Katalin Kiss, Jan Laco, Neha Mittal, Sunil Pasricha, Spinder Samra, Nina Zidar, Martin Bullock, Rebecca Chernock, William Faquin, Shao Hui Huang, Jean Yang, Sun Och Yoon","doi":"10.1007/s12105-025-01753-7","DOIUrl":"10.1007/s12105-025-01753-7","url":null,"abstract":"<p><strong>Purpose: </strong>Extranodal extension (ENE) increases the risk of recurrence and death in head and neck squamous cell carcinoma (HNSCC) patients and is an indication for treatment escalation. Histopathology forms the mainstay of diagnosing ENE. There is substantial variation in the diagnosis of ENE and related terminology. Harmonising the diagnostic criteria for ENE was identified as a priority by the Head and Neck Consensus Language for Ease of Reproducibility (HN CLEAR) Steering Committee and its global stakeholders.</p><p><strong>Methods: </strong>An international working group including 16 head and neck pathologists from eight countries across five continents evaluated whole slide images of haematoxylin and eosin-stained sections depicting potential diagnostic problems through nine virtual meetings to develop consensus guidelines.</p><p><strong>Results: </strong>ENE should be diagnosed only when viable carcinoma extends through the primary lymph node (LN) capsule and directly interacts with the extranodal host environment with or without desmoplastic stromal response. Identifying the original LN capsule and reconstruction of its contour can assist in the detection and assessment of ENE. The term matting is recommended for confluence of two or more nodes due to histologically identifiable tumour extending from one LN to another. Matting constitutes major form of ENE. On the other hand, the terms fusion/adhesion/confluence/conglomeration and other synonyms of adhesion should be limited to confluence due to fibrosis or inflammation without histologically identifiable tumour between involved lymph nodes. Tumour extension along narrow needle tracks or spillage of cyst contents following an FNA do not constitute ENE.</p><p><strong>Conclusions: </strong>The consensus recommendations encompassing the definition of ENE, macroscopic and histologic examination of lymph nodes (LN) and practical guidelines for handling challenging cases are provided.</p>","PeriodicalId":47972,"journal":{"name":"Head & Neck Pathology","volume":"19 1","pages":"20"},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Criteria for Oral Epithelial Dysplasia: Predicting Malignant Transformation.","authors":"Amanda Zimmer Rodrigues, Natalia Koerich Laureano, Bruna Jalfim Maraschin, Alessandra Dutra da Silva, Viviane Palmeira da Silva, Pantelis Varvaki Rados, Fernanda Visioli","doi":"10.1007/s12105-025-01754-6","DOIUrl":"10.1007/s12105-025-01754-6","url":null,"abstract":"<p><strong>Purpose: </strong>In 2022, the World Health Organization (WHO) proposed new criteria for the diagnosis of oral epithelial dysplasia (OED), however their association with patient's outcome is still unknown. This study compared the different classification systems of OED and evaluate their efficacy in predicting malignant transformation.</p><p><strong>Methods: </strong>A total of 195 slides of leukoplakia and erythroplakia were graded according to the WHO 2017, 2022, and the Binary System classification, and were correlated with the lesion's evolution.</p><p><strong>Results: </strong>A progressive increase in malignant transformation according to the severity of OED, with both the WHO and the Binary classification systems was detected. Among individual criteria, changes in cell morphology were independently associated with an increased risk of malignant transformation (HR = 2.8, 95%CI 1.1-7.5, p = 0.032). Considering the new set of OED criteria published in 2022, it was detected that a new cutoff of 4 architectural alterations and 6 cytological alterations predicts better malignant transformation.</p><p><strong>Conclusion: </strong>Malignant transformation was equally predicted by the OED classification systems. Due to the increased number of architectural and cytological features in WHO 2022, a new cutoff for classifying OED from low to high-grade considering 4 architectural and 6 cytological alterations is proposed. The findings allow a more accurate assessment of malignant transformation risk in OED.</p>","PeriodicalId":47972,"journal":{"name":"Head & Neck Pathology","volume":"19 1","pages":"21"},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}