Squamous Cell Carcinoma of Larynx, Hypopharynx, and Trachea
Epidemiology and Etiology:
Common sites:
Gross features:
- Flat or raised edge, polypoid, exophytic, verrucous
- Ulcerative maybe
- Erythematous to white or tan
- Firm on palpation frequently
Histologic features:
- Invasion of the basement membrane
- Broad infiltration maybe
- Jagged, individual cell infiltration maybe
(worse prognosis)
- Overlying surface may not be atypical, and yet
invasion may develop from the base
- Dysplastic changes as described in squamous cell
precursors
- Rich inflammatory infiltrate (lymphocytes and
plasma cells usually)
- Dense, desmoplastic fibrous stroma
- Perineural
invasion maybe (correlation with metastatic potential
- Superficially invasive or deeply invasive
- Differentiation:
- Well – closesly resembles
normal squamous mucosa
- Moderately – distinct nuclear pleomorphism and less keratinization
- Poorly – immature cells with little maturation
or keratinization
- Presence or absence of keratinization
- Verrucous squamous cell carcinoma:
- Spindle cell (sarcomatoid)
squamous cell carcinoma:
- Basaloid squamous cell carcinoma:
- Adenosquamous
cell carcinoma
Immunophenotype:
Marker:
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Sensitivity:
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Specificity:
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Molecular features:
Other features:
- TNM incorporates site, size, and stage
- Laser excision, limited resection, radiation
therapy
- Neoadjuvant chemotherapy and radiation
occasionally
- Delayed, salvaged partial or total laryngectomy
can still achieve a good patient outcome
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References:
- Thompson LDR, ed. Head and Neck Pathology: A volume in the
series Foundations in Diagnostic Pathology (2006).