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Ciliated Adenosquamous Carcinoma: Expanding the Phenotypic Diversity of Human Papillomavirus-Associated Tumors

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Abstract

This study describes a unique subset of ciliated, human papillomavirus (HPV) related, adenosquamous carcinomas (AsqCA) of the head and neck that in contrast to most AsqCA, often show areas with lower grade cytonuclear features. They are comprised of largely non-keratinizing squamous cell carcinoma components with cystic change, gland formation, mucin production, and cilia in tumor cells. Seven cases of ciliated AsqCA were retrieved. Site distribution was as follows: palatine tonsil—3/7, base of tongue—1/7, and neck (unknown primary site)—3/7. Despite the occasional resemblance to mucoepidermoid carcinoma (MEC), the tumors showed focal keratinizing morphology and atypia, and all tumors were negative for MAML2 rearrangements. Oropharyngeal and neck tumors were uniformly p16 positive and showed punctate staining by in situ hybridization for high risk HPV DNA. There were two distant metastases (lung), and one tumor related death. Thus, ciliated AsqCA are HPV-associated lesions that pose unique pitfalls, closely mimicking MEC and other salivary gland tumors. These tumors add to the list of those which defy the dogma that ciliated epithelium always equates to a benign process.

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Acknowledgments

The authors would like to thank the University of Pittsburgh Pathology Research Immunohistochemistry and In situ Hybridization Laboratory for their excellent work in performing the ancillary testing for this study.

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Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, Presbyterian-Shadyside Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, 15232, USA

    Lisa Radkay-Gonzalez & Raja R. Seethala

  2. Department of Pathology, Massachusetts General Hospital, Boston, MA, 02114, USA

    William Faquin

  3. Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA

    Jonathan B. McHugh

  4. Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, 63110, USA

    James S. Lewis Jr.

  5. Department of Pathology, Microbiology and Immunology, Vanderbilt University, Nashville, TN, 37232, USA

    James S. Lewis Jr.

  6. Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA, 19107, USA

    Madalina Tuluc

  7. A614.X Presbyterian University Hospital, 200 Lothrop St, Pittsburgh, PA, 15213, USA

    Raja R. Seethala

Authors
  1. Lisa Radkay-Gonzalez
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  2. William Faquin
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  3. Jonathan B. McHugh
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  4. James S. Lewis Jr.
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  5. Madalina Tuluc
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  6. Raja R. Seethala
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Correspondence to Raja R. Seethala.

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Radkay-Gonzalez, L., Faquin, W., McHugh, J.B. et al. Ciliated Adenosquamous Carcinoma: Expanding the Phenotypic Diversity of Human Papillomavirus-Associated Tumors. Head and Neck Pathol 10, 167–175 (2016). https://doi.org/10.1007/s12105-015-0653-x

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  • DOI: https://doi.org/10.1007/s12105-015-0653-x

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