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Top Ten Oncocytic Head and Neck Lesions to Contemplate

  • SPECIAL ISSUE: TOP TEN HEAD AND NECK DIFFERENTIALS
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Abstract

Background

Oncocytes are a component of many metaplastic and neoplastic lesions throughout the head and neck area, primarily originating in salivary/seromucinous glands and the thyroid gland. In addition, other lesions can contain cells that mimic oncocytes (pseudo-oncocytes); these can be of epithelial or non-epithelial origin.

Methods

Review article.

Results

Oncocytic metaplasia is common in seromucinous glands throughout the upper aerodigestive tract, most notable in the oral cavity, nasopharynx and larynx. The main oncocytic salivary gland neoplasms are Warthin tumor and oncocytoma. Infarction of Warthin tumor may lead to recognition difficulties. Oncocytic subtypes of mucoepidermoid carcinoma and intraductal carcinoma have morphologic and immunohistochemical features that allow distinction from major oncocytic entities. Oncocytic thyroid tumors include adenoma, carcinoma (follicular, papillary and medullary), along with poorly differentiated tumors. Oncocytic papillary sinonasal and middle ear tumors must be distinguished from low grade adenocarcinomas. Pseudo-oncocytic entities include paraganglioma, Langerhans cell histiocytosis, giant cell tumor, rhabdomyoma, and metastatic tumors.

Conclusions

Correct diagnosis of oncocytic head and neck lesions requires a knowledge of the spectrum of possible entities, their characteristic sites of occurrence, architecture, histomorphology, and immunohistochemistry. Oncocytic subtypes of several newly described entities are now recognized. Both epithelial and non-epithelial mimics of oncocytes exist. The molecular features of oncocytic tumors can be helpful in their diagnosis and understanding their pathogenesis.

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Data Availability

Data and material included in this review article is from the author’s own case or consultation material, and is available at the author’s institution(s).

Code Availability

Not applicable.

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Authors and Affiliations

  1. Department of Pathology, Dalhousie University, Halifax, NS, Canada

    Martin J. Bullock

  2. Department of Pathology, Duke University, Durham, NC, USA

    Xiaoyin S. Jiang

  3. Division of Anatomical Pathology, Queen Elizabeth II Health Sciences Centre, Room 742 – 5788 University Avenue, Halifax, NS, B3H 1V8, Canada

    Martin J. Bullock

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Bullock, M.J., Jiang, X.S. Top Ten Oncocytic Head and Neck Lesions to Contemplate. Head and Neck Pathol 17, 53–65 (2023). https://doi.org/10.1007/s12105-022-01520-y

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