Fine Needle Aspiration Biopsy Of HPV Related Squamous Cell Carcinomas Of The Oropharynx | 51550
Journal of Cytology & Histology
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Human papilloma virus (HPV) related oropharyngeal squamous cell carcinoma (SCC) is a unique form of carcinoma that is
important to identify for prognosis and treatment. Patients with HPV related oropharyngeal SCC have a much better prognosis
and an enhanced response to radiation and chemotherapy compared to patients with conventional (HPV-negative) SCC of the head
and neck. A significant proportion of patients with head and neck SCC present with neck masses as their first symptom. Fine needle
aspiration (FNA) of cervical lymph nodes is fast, easy to perform, minimally invasive and accurate as a modality for the diagnosis of
metastatic SCC. While morphologic features, particularly a non keratinizing phenotype, strongly predict an association with HPV,
ancillary studies are often used to confirm the diagnosis. A common and readily available modality is immunohistochemical staining
for p16, an excellent surrogate marker for transcriptionally active, high-risk HPV. Even focal, strong and confluent p16 positive
staining of FNA biopsy material correlates with high risk HPV. Alternatively, high risk HPV can be detected directly by RNA in situ
hybridization and other molecular based approaches, some of which are already routinely used in gynecologic cervical specimens.
The objective of the presentation will be to discuss FNA of HPV related oropharyngeal SCC and to explore the different ancillary
testing methods that are used to make the diagnosis.
Cory Bernadt has earned his MD and PhD from the University of Nebraska Medical Center. He has completed his Residency in Anatomic Pathology and Surgical Pathology Fellowship at the University of Iowa Hospitals and Clinics. He has received his training in Cytopathology from the University of Virginia. He is currently an Assistant Professor in the Department of Pathology and Immunology at Washington University School of Medicine in St. Louis.