Head and Neck Pathology
Parisa Mokhles; Alireza Sadeghipour; Maryam Kadivar; Nasrin Shayanfar; Zahra Keshtpour Amlashi; Pegah Alizadeh Pahlavan; Ashkan Shafiei
Abstract
Sclerosing microcystic adenocarcinoma (SMA) is an uncommon neoplasm of the oral cavity, with only 14 reported cases documented in the literature.We present a case of SMA in a 65-year-old woman with a history of high-grade lymphoma who developed clear cell changes in the deep muscular layer of the ...
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Sclerosing microcystic adenocarcinoma (SMA) is an uncommon neoplasm of the oral cavity, with only 14 reported cases documented in the literature.We present a case of SMA in a 65-year-old woman with a history of high-grade lymphoma who developed clear cell changes in the deep muscular layer of the tongue.Currently, the diagnosis of SMA relies on careful morphological evaluation and the exclusion of other potential differential diagnoses.
Head and Neck Pathology
Parisa Khorasani Esmaili; Shahriar Dabiri; Ayeh Shamsadini; Tooraj Reza Mirshekari
Abstract
Malignant melanoma of the sinonasal area is a rare tumor that arises from melanocytes in the nasal mucosa and is more aggressive than the cutaneous type with a poor prognosis.We report a 60-year-old female with the initial chief complaint of nasal cavity fullness, continuous epistaxis, and nasal bone ...
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Malignant melanoma of the sinonasal area is a rare tumor that arises from melanocytes in the nasal mucosa and is more aggressive than the cutaneous type with a poor prognosis.We report a 60-year-old female with the initial chief complaint of nasal cavity fullness, continuous epistaxis, and nasal bone deformity in the past two months.In a primary examination, a black mass was found, and in an excisional biopsy, the pathologist reported sinonasal malignant melanoma, which was confirmed after IHC staining.In spindle cell tumors of the head and neck area, we should be aware of mucosal malignant melanoma as a differential diagnosis.
Head and Neck Pathology
Lisnawati Rachmadi; Ela Laelasari; Yayi Dwina Bilianti; Kusmardi Kusmardi
Abstract
Background & Objective: The expression of matrix metalloproteinase-9 (MMP-9) and chemokine receptor 7 (CCR7) is significantly associated with tumor invasion and metastasis. Little is known regarding the potential of these markers in predicting cancer metastasis in Laryngeal Squamous Cell Carcinoma ...
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Background & Objective: The expression of matrix metalloproteinase-9 (MMP-9) and chemokine receptor 7 (CCR7) is significantly associated with tumor invasion and metastasis. Little is known regarding the potential of these markers in predicting cancer metastasis in Laryngeal Squamous Cell Carcinoma (LSCC). Therefore, this study aimed to dissect the potential of these markers in predicting the lymph node metastasis in LSCC patients.Methods: Sixty tissue samples were obtained from the patients diagnosed pathologically with LSCC who underwent partial or total laryngectomy. The expression of MMP-9 and CCR7 was measured using the immunohistochemistry staining in the tissue samples of LSCC patients. The ROC (receiver operating characteristic) curve was used to determine the most significant cut-off points of expression according to the highest sensitivity and specificity of both the markers to predict the lymph node metastasis in LSCC. Then, the relationship between the clinicopathology features and the expression of MMP-9 and CCR7 was evaluated.Results: The expression of both MMP-9 and CCR7 was significantly correlated with the lymph node metastasis in LSCC (P<0.001). Furthermore, CCR7 expression exhibited the highest prediction accuracy (AUC 95.7%) and sensitivity (100%) in predicting the lymph node metastasis in LSCC compared to that of MMP-9 (AUC 92.9%, sensitivity 90%). We also found that patients with larger tumor size (> 4 cm) had significantly higher expression of MMP-9 and CCR7 (P<0.002 and P<0.001, respectively). The Elevated expression level of CCR7 statistically correlated with higher MMP-9 expression (P<0.001).Conclusion: MMP-9 and CCR7 might be beneficial as predictors of lymph node metastasis in LSCC patients.
Head and Neck Pathology
Aarya Unnikrishnan; Vijaya Basavaraj
Abstract
Background & Objective: Head and Neck Squamous Cell Carcinoma (HNSCC) is a highly frequent malignancy worldwide and is also the leading cause of death. The prognosis for individuals with HNSCC remains dismal, with a five-year survival rate of less than 50%. The novel anti-PD-L1 immunotherapy is found ...
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Background & Objective: Head and Neck Squamous Cell Carcinoma (HNSCC) is a highly frequent malignancy worldwide and is also the leading cause of death. The prognosis for individuals with HNSCC remains dismal, with a five-year survival rate of less than 50%. The novel anti-PD-L1 immunotherapy is found to be promising, and immunohistochemistry (IHC) has been established as a reliable method for patient stratification. We intend to evaluate the prognostic significance of the expression of programmed death ligand-1 (PD-L1) in HNSCC and determine its association with clinicopathological variables.Methods: A total of 50 cases of biopsy-confirmed HNSCC were studied in a tertiary hospital between Dec 2020 and June 2022. The specimens were tested for PD-L1 IHC expression with antibody clone CAL-10 (Biocare) and scored by Combined Positive Score (CPS). The association between PD-L1 expression and clinicopathological variables was evaluated.Results: PD-L1 was positive in 92% of the cases, and a significant association (P= 0.024) was seen between PD-L1 expression and tumor-infiltrating lymphocytes (TILs). PD-L1 did not show any significant association with patient demographics, tumor site, grade, or stage.Conclusion: In the present study, evaluation of the immunohistochemical expression of PD-L1 on the tumor cells and TILs in HNSCC revealed a high prevalence of PD-L1 expression. PD-L1 IHC studies for patient selection for immunotherapy would be a promising technique. Frequent PD-L1 expression in tumors with significant TILs may be useful in identifying patients who may benefit from anti-PD-1/PD-L1 therapy.
Head and Neck Pathology
Shokouh Taghipour Zahir; Fatemeh Derakhshani; Mohammad Reza Vahidy; Mojtaba Meybodian
Abstract
Angiosarcoma is a malignant vascular tumor that occurs mostly in the soft tissues, skin, trunk, and limbs. Angiosarcoma of the parotid gland is a very uncommon and rare tumor.Herein, we presented a case of a 66-year-old man who was referred for a lump in his neck and his initial biopsy reported Castleman ...
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Angiosarcoma is a malignant vascular tumor that occurs mostly in the soft tissues, skin, trunk, and limbs. Angiosarcoma of the parotid gland is a very uncommon and rare tumor.Herein, we presented a case of a 66-year-old man who was referred for a lump in his neck and his initial biopsy reported Castleman disease. After three months during which the mass did not resolve, a re-biopsy was performed. The biopsy revealed vascular neoplasm composed of neoplastic spindle cells arranged in fascicles with red blood cells between them in the lymph node. This metastatic angiosarcoma was confirmed by immunohistochemical staining. Neoplastic cells were positive for vimentin, EMA, and CD31. The patient underwent radiation therapy. Nine months later, MRI (magnetic resonance imaging) showed a tumor in the parotid gland. The microscopic examination revealed a primary angiosarcoma of the parotid.Although primary angiosarcoma of the parotid gland is very rare, it should be considered as a possible origin in metastatic angiosarcoma of the neck. Further research is recommended on the subject.
Head and Neck Pathology
Sahar Assar; Sepideh Assar; Heidar-Ali Mardanifard; Zohreh Jaafari-Ashkavandi
Abstract
Background & Objective: There is no consensus on the prevalence of salivary gland tumors (SGTs) in Iran. Thus, we systematically reviewed the literature about the prevalence of SGTs in Iran and applied the last world health organization (WHO) classification.Methods: The systematic literature search ...
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Background & Objective: There is no consensus on the prevalence of salivary gland tumors (SGTs) in Iran. Thus, we systematically reviewed the literature about the prevalence of SGTs in Iran and applied the last world health organization (WHO) classification.Methods: The systematic literature search was performed in EMBASE, Scopus, PubMed MEDLINE, Google Scholar, Scientific Information Database (SID), and Magiran; we searched for "salivary gland," "tumor," "prevalence," and "Iran" until 1 March 2021. The studies included were written in the English and Farsi languages. The weighted mean prevalence of SGTs was calculated as prevalence (%) * (N/the sum of all N). We used the unpaired Two-sample T-test to compare the weighted means.Results: A total of 17 studies, including 2870 patients, were selected for the data synthesis. The weighted mean prevalence of benign and malignant tumors was 66% (95% CI: 59-73) and 34% (95% CI: 27-41), respectively. The patients' mean age was reported in 10 out of the 17 studies. The weighted mean age of the patients was 40 (95% CI: 37-42) and 49 (95% CI: 43-55) years for benign and malignant tumors, respectively (P=0.01). Pleomorphic adenoma (PA), followed by Warthin's tumor (WT), was the most prevalent benign tumor. Moreover, the most common malignant tumors were mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma (AdCC).Conclusion: More than one-third of SGTs in Iran were malignant, which is higher than the reports from Middle Eastern countries. Information about risk factors and the burden of SGTs in Iran is insufficient. Thus, further well-designed longitudinal studies are warranted.
Head and Neck Pathology
Dalia Nabil Abdelhafez; Maram Mostafa Ayoub; Samira A. Mahmoud; Hala M. El-hanbuli
Abstract
Background & Objective: One of the most prevalent endocrine system cancers is papillary thyroid carcinoma, with complicated predisposing factors and pathogenesis. YAP1 (Yes-associated protein 1) is a well-known oncogene; its activity is increased in a variety of human malignancies and has recently ...
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Background & Objective: One of the most prevalent endocrine system cancers is papillary thyroid carcinoma, with complicated predisposing factors and pathogenesis. YAP1 (Yes-associated protein 1) is a well-known oncogene; its activity is increased in a variety of human malignancies and has recently been paid great attention. The present study examines YAP1 and P53 immunohistochemical expression in papillary thyroid carcinoma and investigates the association of their expression with the available clinicopathological risk factors to assess their possible prognostic role.Methods: The current study used paraffin blocks of 60 cases of papillary thyroid carcinoma, which were immunohistochemically assessed for YAP1 and p53 expression. The study examined the association of their expression with clinicopathological characteristics.Results: YAP1 expression was observed in 70% of papillary thyroid carcinoma cases. A statistically significant relation was observed between YAP1 expression and tumor size, tumor stage, tumor focality, lymph node metastases, and extrathyroidal extension (P-values were =0.003, > 0.001, 0.037, 0.025, and 0.006), respectively. p53 expression was observed in 85% of papillary thyroid carcinoma cases. A statistically significant relation was observed between p53 expression and tumor size (P=0.001) and tumor stage (P>0.001). A statistically significant relation was noticed between YAP1 and P53 expression (P=0.009).Conclusion: YAP1 expression was found to be associated with many high-risk clinicopathological characteristics in patients with papillary thyroid carcinoma and with p53 expression; thus, it seems that YAP1 may have a specific impact on the patient's outcome.
Head and Neck Pathology
Anjali Mary JIbi; Vijaya Basavaraj
Abstract
Background & Objective: Head and Neck Squamous cell carcinoma (HNSCC) is one of the leading cancers worldwide. Cervical lymph node metastasis is the most adverse prognostic factor for patients with HNSCC. As there are no reliable factors in predicting lymph node metastasis, recent researchers focus ...
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Background & Objective: Head and Neck Squamous cell carcinoma (HNSCC) is one of the leading cancers worldwide. Cervical lymph node metastasis is the most adverse prognostic factor for patients with HNSCC. As there are no reliable factors in predicting lymph node metastasis, recent researchers focus on identifying various metastasis markers that will aid treatment selection. Podoplanin is a recent marker strongly associated with lymph node metastasis, aggressive tumor behavior, and poor prognosis. The expression of podoplanin in human squamous cell cancers and its association with cancer cell motility suggest a possibility that it could be used as a biomarker to predict lymph node metastasis. To study the expression of podoplanin in head and neck squamous cell carcinoma, determine its association with clinicopathological variables, and predict its use as a biomarker in predicting lymph node metastasis.Methods: The present study was conducted in a tertiary care hospital. Podoplanin expression was studied in 45 cases of HNSCC and its association with clinicopathological variables. The predictive power of podoplanin was further analyzed using univariate and multivariate logistic regression analysis. The positive and negative predictive values of podoplanin were determined concerning the presence or absence of lymph node metastasis.Results: Podoplanin expression is significantly associated with histological grade (P=0.03) and lymph node metastasis (P=0.01). In logistic regression analysis, podoplanin expression (Odds Ratio: 5.66, Confidence Interval: 1.23 -25.87, P=0.02) was a significant independent predictor of lymph node metastasis.Conclusion: Our study demonstrates that podoplanin provides prognostic information and predicts lymph node metastasis which was consistent with our studies in the literature. Thus, podoplanin may help better stratify patients selected for elective neck node dissection in early tumor stages and clinically negative regional disease.
Oral Pathology
Vaishnavi Vedam; Sivadas Ganapathy
Abstract
Dear EditorHead and Neck Cancers (HNCs) contribute to one of the global health concerns and have been a challenge to oncologists for decades. Breakthroughs in research with evidence-based reports based on diagnostic and therapeutic approaches in clinical practice have been published to address patient ...
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Dear EditorHead and Neck Cancers (HNCs) contribute to one of the global health concerns and have been a challenge to oncologists for decades. Breakthroughs in research with evidence-based reports based on diagnostic and therapeutic approaches in clinical practice have been published to address patient concerns. Risk factors, namely age, sex, diet, habits, and geographical variations, pose an established link with the prevalence of HNCs. Despite ongoing studies in cancer, the 5-year survival rate of the patients remains <50% to date. This has encouraged the scientists to research other possible novel risk factors and prognosis transformers that could present as targets for preventive or therapeutic interventions.
Head and Neck Pathology
Hamideh Kadeh; Shirin Saravani; Ebrahim Miri-Moghadam
Abstract
Background & Objective: Epithelial-Mesenchymal transition (EMT) is known to be a possible mechanism in tumor progression; however, there is insufficient evidence to support the contribution of this process in human cancers. The present study aimed to evaluate the expression of EMT markers in normal ...
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Background & Objective: Epithelial-Mesenchymal transition (EMT) is known to be a possible mechanism in tumor progression; however, there is insufficient evidence to support the contribution of this process in human cancers. The present study aimed to evaluate the expression of EMT markers in normal oral epithelium and oral squamous cell carcinoma and also correlates with some clinicopathological parameters.Methods: This study was conducted on 70 samples, including 20 cases of normal epithelium and 50 cases of Oral Squamous cell Carcinoma (OSCC). To examine the expression level of these proteins, immunohistochemical staining was performed for samples using E-cadherin and N-cadherin monoclonal antibodies.Results: Reduced expression of E-cadherin was observed in 74% of OSCC and 15% of normal epithelium samples; this difference was statistically significant (P˂0.000). With the progression of SCC from well towards poor differentiation, the E-cadherin expression decreased; however, this difference was not statistically significant (P=0.642). Normal epithelial specimens were negative for N-cadherin expression in 75% of cases, whereas OSCC specimens showed high expression of N-cadherin in 46% of cases, this difference was statistically significant (P=0.01). Although 62.5% of poorly differentiated OSCC showed high expression of N-cadherin, the difference between the histopathological grades was not significant (P=0.586). No significant relationship was found between markers expression and patient’s age, gender, and tumor location.Conclusion: This study showed that OSCC tissues showed high EMT phenotype (reduced E-cadherin expression and high expression of N-cadherin) compared to normal oral mucosa which may indicate the possible key role of EMT mechanism during oral carcinogenesis.
Head and Neck Pathology
Maryam Ghasemi; Laleh Vahedi Larijani; Jamshid azdani-Charati; Elham Kamali Hakim
Abstract
Background & Objectives: Galectin-8 has relationships with cell growth and metastasis of some cancers. Due to controversy in the clinical significance of this protein in the cancer process, we investigated its roles in the development of head and neck squamous cell carcinoma. Methods: This study ...
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Background & Objectives: Galectin-8 has relationships with cell growth and metastasis of some cancers. Due to controversy in the clinical significance of this protein in the cancer process, we investigated its roles in the development of head and neck squamous cell carcinoma. Methods: This study was performed on 93 samples of patients with Squamous Cell Carcinoma or dysplasia of the head and neck, who underwent biopsy or surgery from 2015 till 2017 in Boo-Ali SINA hospital of Sari, Iran. The relevant paraffin embedded tissue blocks were obtained from archive of pathology and evaluated for galectin-8 by immunohistochemistry. The association between expression of galactin-8 and age, sex, location and stage of disease were assessed. To compare expression rate between the groups, Mc-Nemar, Chi-square and Fisher's exact tests were used. The P-value Results: Strong cytoplasmic and nuclear galactin-8 staining was observed in 97.6% cases of normal tissues while 77% of dysplastic lesions and 69% of the cancers revealed negative immunoreactivity. The intensity of expression in dysplastic and malignant tissues was significantly reduced compared with normal tissues (p =0.0001). The expression of galectin-8 did not correlate with stage (p =0.303), lymph node involvement (p =0.326), tumor grade (p =0.769), distant metastasis (p =0.748), and age (p =0.574). Conclusion: We observed that the expression of galectin-8 in dysplastic and malignant squamous epithelium significantly reduced compared with the normal counterpart of them in the head and neck. It may contribute to malignant transformation of head and neck squamous cells.
Head and Neck Pathology
Mitra Rezaei; Mahboobeh Karimi-Galougahi; Azin Kheradmand; Mihan Pourabdollah Toutkaboni; Hassan Mir Mohammad Sadeghi; Alireza Abdollahi; Amirnader Emami Razavi; Ali Safavi Naini; Farahnaz Bidari- Zerehpoosh
Abstract
Background & Objective: Human papillomavirus (HPV) has been associated with prognosis in patients with head and neck squamous cell carcinoma (HNSCC). Similar to the global studies, different prevalence rates of this viral infection have been reported in Iran. Therefore, we aimed to report the prevalence ...
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Background & Objective: Human papillomavirus (HPV) has been associated with prognosis in patients with head and neck squamous cell carcinoma (HNSCC). Similar to the global studies, different prevalence rates of this viral infection have been reported in Iran. Therefore, we aimed to report the prevalence of this virus and its significance in HNSCC patients.Methods: Patients who were referred to the five hospitals of Tehran city from May 2018 to May 2019 were enrolled in this study. All patients were diagnosed with HNSCC based on pathologic study. The pathologic disease staging was defined, and DNAs were extracted from the fresh tissue samples via kits. After polymerase chain reaction (PCR), HPV positive samples were evaluated for determining genotypes and data analysis.Results: Of the 46 patients, three patients (6.5%) had positive HPV with the following subtypes: 18 (in two patients), 52 (in three patients), 61 (in two patients), 67, and 73.Comparison of variables between the groups with and without HPV showed a significant difference based on the tumor’s lymphatic invasion (p =0.041), peripheral lymph node involvement (p =0.008), and histologic grade (p =0.011), but there was no statistically significant difference in terms of other variables such as age, primary tumor site, size, pathologic stage, vascular or perineural invasion, metastasis, smoking, and alcohol consumption.Conclusion: HPV positivity is an important factor in the lymphatic invasion, peripheral lymph node involvement, and histologic grade of cases with HNSCC and should be further investigated for its effect on prognosis.
Head and Neck Pathology
Vahid Zand; Fariba Binesh; Mojtaba Meybodian; Farzan Safi Dahaj; Arezoo Alamdar yazdi
Abstract
Background & Objective: Laryngeal squamous cell carcinoma (LSCC) is considered to be one of the most common cancers of the head and neck, accounting for roughly 90% of all malignant tumors of the larynx. To have a timely diagnosis for a better and practical therapy, molecular markers have to be investigated. ...
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Background & Objective: Laryngeal squamous cell carcinoma (LSCC) is considered to be one of the most common cancers of the head and neck, accounting for roughly 90% of all malignant tumors of the larynx. To have a timely diagnosis for a better and practical therapy, molecular markers have to be investigated. The aim of this study was to determine the expression of Cyclin D1 (CD1) in patients with laryngeal squamous cell carcinoma. Methods: In this study the demographic data of 82 patients with laryngeal squamous cell carcinoma, including age, gender and geographical region history of smoking and drug abuse, paraclinical findings, surgical description, and pathologic reports were extracted from their medical records. The stage and grade of the disease and tumor location were determined using their medical records. An appropriate tissue sample was selected. Then, the selected cancerous tissue samples stored as formalin-fixed paraffin-embedded tissue then were (Immunohistochemistry) IHC stained and analyzed in terms of the expression of CD1. Result & Conclusion : According to the results, 75 out of 82 (91.5%) investigated samples were positive for CD1 expression. There was a significant relationship between stage of the disease (P=0.041) and CD1 expression in patients with laryngeal squamous cell carcinoma. There was no significant relationship between gender (P=0.055), age (P=0.256), history of smoking and drug abuse (P=0.192), location of the tumor (P=0.90), grade of the disease (P=0.515) and geographical region (P=0.466) and CD1 expression in patients with laryngeal squamous cell carcinoma. The results of the present study showed that CD1 expression was higher (91.5%) in patients with laryngeal squamous cell carcinoma in comparison to the other studies. According to the results we can conclude that stage of the disease can significantly affect CD1 expression in patients with squamous cell carcinoma.
Head and Neck Pathology
Hassan Mir Mohammad Sadeghi; Abbas Karimi; Amirsina Rahpeima; Samira Derakhshan
Abstract
Salivary duct carcinoma (SDC) is a rare and highly aggressive salivary gland tumor with poor prognosis, rapid growth, distant metastasis, early regional metastasis, and a high rate of recurrence. The parotid gland is the most common site of involvement, and the lungs and the bones are the most common ...
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Salivary duct carcinoma (SDC) is a rare and highly aggressive salivary gland tumor with poor prognosis, rapid growth, distant metastasis, early regional metastasis, and a high rate of recurrence. The parotid gland is the most common site of involvement, and the lungs and the bones are the most common sites of distant metastasis of SDC. Herein, we present a case of SDC of the parotid gland in a 62-year-old male patient with an unusual metastasis to the skin of the primary site and brain 6 years after primary treatment, which comprised of total parotidectomy and radical neck dissection followed by radiotherapy. It is noteworthy that in few cases of SDC with infiltration, (and not in low-grade intraductal carcinoma of the salivary glands), routine treatment may not suffice, and long-term follow-up is highly recommended.
Head and Neck Pathology
Behrouz Shokouhi; Parisa Mehrasa; Farzad Aslani
Abstract
Respiratory epithelial adenomatoid hamartoma (REAH) is an uncommon lesion of the upper aerodigestive tract. It is characterized by abnormal glandular formations with ciliated epithelium arising from the nasal cavity, paranasal sinuses and nasopharynx, but other locations have also been described. We ...
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Respiratory epithelial adenomatoid hamartoma (REAH) is an uncommon lesion of the upper aerodigestive tract. It is characterized by abnormal glandular formations with ciliated epithelium arising from the nasal cavity, paranasal sinuses and nasopharynx, but other locations have also been described. We did not find any other cases of this hamartomas in the external auditory canal in the literature. A 40-year-old man was referred to the otorhinolaryngology department due to otorrhea and decreased hearing from 1 year ago. Otoscopic examination showed a reddish hemorrhagic mass in the left external auditory canal. Intraoperatively, the tumor was completely resected. The pathologic findings were consistent with REAH.