Pathology of the Head and Neck

Contents1 Benign and Potentially MalignantLesions of the Squamous Epitheliumand Squamous Cell Carcinoma . . . . 1N. Gale, N. Zidar1.1 Squamous Cell Papillomaand Related Lesions . . . . . . . . . . . . . 21.1.1 Squamous Cell Papilloma, Verruca Vulgaris,Condyloma Acuminatumand Focal Epithelial Hyperplasia . . . . . 21.1.2 Laryngeal Papillomatosis . . . . . . . . . 31.2 Squamous Intraepithelial Lesions (SILS) 41.2.1 General Considerations . . . . . . . . . . 41.2.2 Terminological Problems . . . . . . . . . 41.2.3 Aetiology . . . . . . . . . . . . . . . . . . . 51.2.3.1 Oral Cavity and Oropharyn . . . . . . . . . 51.2.3.2 Larynx . . . . . . . . . . . . . . . . . . . . 51.2.4 Clinical Featuresand Macroscopic Appearances . . . . . . . 61.2.4.1 Oral and Oropharyngeal Leukoplakia,Proliferative Verrucous Leukoplakiaand Erythroplakia . . . . . . . . . . . . . . 61.2.4.2 Laryngeal and HypopharyngealLeukoplakia and Chronic Laryngitis . . . 71.2.5 Histological Classifications . . . . . . . . . 81.2.5.1 WHO Dysplasia System . . . . . . . . . . 81.2.5.2 The Ljubljana Classification . . . . . . . . 91.2.5.3 Comparison Betweenthe Ljubljana Classificationand WHO 2005 Classification . . . . . . . 111.2.6 Biomarkers Related to Malignant Potentialof SILs Recognised by Auxiliaryand Advanced Molecular Methods . . . . . 121.2.7 Treatment and Prognosis . . . . . . . . . . 121.2.7.1 Oral Cavity and Oropharynx . . . . . . . . 121.2.7.2 Larynx . . . . . . . . . . . . . . . . . . . . . 131.3 Invasive Squamous Cell Carcinoma . . . . 131.3.1 Microinvasive SquamousCell Carcinoma . . . . . . . . . . . . . . . 131.3.2 Conventional SquamousCell Carcinoma . . . . . . . . . . . . . . . 131.3.2.1 Aetiology . . . . . . . . . . . . . . . . . . . 141.3.2.2 Pathologic Features . . . . . . . . . . . . . 141.3.2.3 Grading . . . . . . . . . . . . . . . . . . . . 141.3.2.4 Invasive Front . . . . . . . . . . . . . . . . 151.3.2.5 Stromal Reaction . . . . . . . . . . . . . . 151.3.2.6 Differential Diagnosis . . . . . . . . . . . . 151.3.2.7 Treatment and Prognosis . . . . . . . . . . 151.3.3 Spindle Cell Carcinoma . . . . . . . . . . . 161.3.3.1 Aetiology . . . . . . . . . . . . . . . . . . . 161.3.3.2 Pathologic Features . . . . . . . . . . . . . 161.3.3.3 Differential Diagnosis . . . . . . . . . . . . 171.3.3.4 Treatment and Prognosis . . . . . . . . . . 171.3.4 Verrucous Carcinoma . . . . . . . . . . . . 171.3.4.1 Aetiology . . . . . . . . . . . . . . . . . . . 171.3.4.2 Pathologic Features . . . . . . . . . . . . . 181.3.4.3 Differential Diagnosis . . . . . . . . . . . . 181.3.4.4 Treatment . . . . . . . . . . . . . . . . . . . 181.3.4.5 Prognosis . . . . . . . . . . . . . . . . . . . 191.3.5 Papillary Squamous Cell Carcinoma . . . . 191.3.5.1 Aetiology . . . . . . . . . . . . . . . . . . . 191.3.5.2 Pathologic Features . . . . . . . . . . . . . 191.3.5.3 Differential Diagnosis . . . . . . . . . . . . 201.3.5.4 Treatment and Prognosis . . . . . . . . . . 201.3.6 Basaloid Squamous Cell Carcinoma . . . . 201.3.6.1 Aetiology . . . . . . . . . . . . . . . . . . . 201.3.6.2 Pathologic Features . . . . . . . . . . . . . 201.3.6.3 Differential Diagnosis . . . . . . . . . . . . 211.3.6.4 Treatment and Prognosis . . . . . . . . . . 211.3.7 Adenoid Squamous Cell Carcinoma . . . . 221.3.7.1 Pathologic Features . . . . . . . . . . . . . 221.3.7.2 Differential Diagnosis . . . . . . . . . . . . 221.3.7.3 Treatment and Prognosis . . . . . . . . . . 221.3.8 Adenosquamous Carcinoma . . . . . . . . 231.3.8.1 Aetiology . . . . . . . . . . . . . . . . . . . 231.3.8.2 Pathologic Features . . . . . . . . . . . . . 231.3.8.3 Differential Diagnosis . . . . . . . . . . . . 231.3.8.4 Treatment and Prognosis . . . . . . . . . . 241.3.9 Lymphoepithelial Carcinoma . . . . . . . 241.3.9.1 Aetiology . . . . . . . . . . . . . . . . . . . 241.3.9.2 Pathologic Features . . . . . . . . . . . . . 241.3.9.3 Differential Diagnosis . . . . . . . . . . . . 251.3.9.4 Treatment and Prognosis . . . . . . . . . . 251.4 Second Primary Tumours . . . . . . . . . . 251.5 Tumour Spread and Metastasising . . . . 251.5.1 Invasion of Lymphaticand Blood Vessels . . . . . . . . . . . . . . 26