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Head and Neck Pathology: Practical Points to Ponder

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As anatomical pathologists seeking to serve clinicians and their patients, we aim to help clinicians to send us the specimens that allow us to do our job well. We have hints about taking, orientating and sending pathology specimens to the laboratory. We explain transport media and give guidance on fine needle aspiration, frozen sections, biopsies and resections. We discuss the ancillary techniques like special stains, immunohistochemistry and molecular studies that distinguish modern pathology from its historical roots. We explain the elements of pathological reports, hopefully demystifying tumour thickness, depth of invasion, pattern of invasion, perineural spread and the pathology of surgical margins.


  • Transport media
  • Fine needle aspirate
  • Frozen section
  • Biopsy and excision specimens
  • Inking
  • Immunohistochemistry
  • Molecular studies
  • Pathology reports

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  • DOI: 10.1007/978-3-030-88334-8_3
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  1. Sarantou T, Compton C (2015) The essential relationship between surgeon and pathologist. The Recovery Room

    Google Scholar 

  2. Rollins SD. Teaching FNA techniques and ultrasound guided FNA. Cancer Cytopathol. 2019;127(1):7–8.

    CrossRef  Google Scholar 

  3. Bibbo M. Comprehensive cytopathology. Philadelphia: Elsevier; 2008.

    Google Scholar 

  4. Orell SR, Sterrett GF, Walters MN-I, Whitaker DW. A manual and atlas of fine needle aspiration cytology. New York: Churchill Livingstone; 1992.

    Google Scholar 

  5. Cibas ES, Ducatman BS. Cytology: diagnostic principles and clinical correlates. Philadelphia: Elsevier; 2014.

    Google Scholar 

  6. Lester SC. Manual of surgical pathology. Edinburgh: Elsevier Churchill Livingstone; 2010.

    Google Scholar 

  7. Layfield EM, Schmidt RL, Esebua M, Layfield LJ, LJ. Frozen section evaluation of margin status in primary squamous cell carcinomas of the head and neck: a correlation study of frozen section and final diagnoses. Head Neck Pathol. 2018;12(2):175–80.

    CrossRef  Google Scholar 

  8. VanderLaan PA. Fine-needle aspiration and core needle biopsy: an update on 2 common minimally invasive tissue sampling modalities. Cancer Cytopathol. 2016;124(12):862–70.

    CrossRef  Google Scholar 

  9. Bull AD, Cross SS, James DS, Silcocks PB. Do pathologists have extrasensory perception? BMJ. 1991;303:1604–5.

    CAS  CrossRef  Google Scholar 

  10. Sezgin B, Kapucu I, Yenidunya G, Ozmen S, Yavuzer R, Bulutay P, Armutlu A. A practical method for accurate coordination between the plastic surgeon and the pathologist: the clockwork technique. Arch Plast Surg. 2018;45(1):96–7.

    CrossRef  Google Scholar 

  11. Alder L, Coombs NJ. Colour inking of breast wide local excision specimens in theatre: time economy for the surgeon looking to improve departmental pathology diagnostics. Eur J Surg Oncol. 2014;40(11):S90.

    CrossRef  Google Scholar 

  12. Rossi ED, Schmitt F. Pre-analytic steps for molecular testing on thyroid fine-needle aspirations: the goal of good results. Cytojournal. 2013;10(1):24.

    CrossRef  Google Scholar 

  13. Ramos-Vara JA. Technical aspects of immunohistochemistry. Vet Pathol. 2005;42(4):405.

    CAS  CrossRef  Google Scholar 

  14. McKinnon KM. Flow cytometry: an overview. Curr Protoc Immunol. 2018;120:1–5.

    CrossRef  Google Scholar 

  15. Zhu S, Schuerch C, Hunt J. Review and updates of immunohistochemistry in selected salivary gland and head and neck tumors. Arch Pathol Lab Med. 2015;139(1):55–66.

    CrossRef  Google Scholar 

  16. Chenghua Cui C, Wei Shu W, Li P. Fluorescence in situ hybridization: cell-based genetic diagnostic and research applications. Front Cell Dev Biol. 2016;4:89.

    PubMed  PubMed Central  Google Scholar 

  17. Renshaw AA, Mena-Allauca M, Gould EW, Sirintrapun SJ. Synoptic reporting: evidence-based review and future directions. JCO Clin Cancer Inform. 2018;2:1–9.

    PubMed  Google Scholar 

  18. Yildiz P, Aung PP, Milton DR, Hruska C, Ivan D, Nagarajan P, Tetzlaff MT, Curry JL, Torres-Cabala C, Prieto VG. Measurement of tumor thickness in cutaneous squamous cell carcinomas: do the different methods provide better prognostic data? Am J Dermatopathol. 2020;42(5):337–42.

    CrossRef  Google Scholar 

  19. Myers JN, Hanna EYN, Myers EN. Cancer of the head and neck. Philadelphia: Wolters Kluwer; 2017. p. 48–9.

    Google Scholar 

  20. Bullock MJ, Beitler JJ, Carlson DL, Fonseca I, Hunt JL, Katabi N, Sloan P, Taylor SM, Williams MD, Thompson LDR. Data set for the reporting of nodal excisions and neck dissection specimens for head and neck tumors: explanations and recommendations of the guidelines from the international collaboration on cancer reporting. Arch Pathol Lab Med. 2019;143(4):452–62.

    CAS  CrossRef  Google Scholar 

  21. Califano JA, Lydiatt WM, Nehal KS, O’Sullivan B, Schmults C, Seethala RR, Weber RS, Shah JP. AJCC cancer staging manual. Cutaneous squamous cell carcinoma of the head and neck. Chicago: Springer; 2017. p. 171–81.

    Google Scholar 

  22. Andreasen S, Kiss K, Mikkelsen LH, Channir HI, Plaschke CC, Melchior LC, Eriksen JG, Wessel I. An update on head and neck cancer: new entities and their histopathology, molecular background, treatment, and outcome. APMIS. 2019;127(5):240–64.

    CrossRef  Google Scholar 

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Correspondence to Bridget Mitchell .

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Mitchell, B., Kee, J.F., Peart, L.K., Mitchell, D. (2022). Head and Neck Pathology: Practical Points to Ponder. In: Burton, I., Klaassen, M.F. (eds) Atlas of Extreme Facial Cancer. Springer, Cham.

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  • Print ISBN: 978-3-030-88333-1

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