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The Most Common Mistake in Laryngeal Pathology and How to Avoid it
Upper aerodigestive tract (UADT) spindle cell squamous carcinoma (SCSC), also known as sarcomatoid carcinoma, is a high-grade subtype of conventional squamous cell carcinoma (SCC) that is histologically characterized by a combination of differentiated SCC in the form of intraepithelial dysplasia and...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8010031/ https://www.ncbi.nlm.nih.gov/pubmed/33723761 http://dx.doi.org/10.1007/s12105-020-01273-6 |
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author | Heidarian, Amin Wenig, Bruce M. |
author_facet | Heidarian, Amin Wenig, Bruce M. |
author_sort | Heidarian, Amin |
collection | PubMed |
description | Upper aerodigestive tract (UADT) spindle cell squamous carcinoma (SCSC), also known as sarcomatoid carcinoma, is a high-grade subtype of conventional squamous cell carcinoma (SCC) that is histologically characterized by a combination of differentiated SCC in the form of intraepithelial dysplasia and/or invasive differentiated SCC, and the presence of an invasive (submucosal) undifferentiated malignant spindle-shaped and pleomorphic (epithelioid) cell component. Typically, SCSC presents as a superficial polypoid mass not infrequently with surface ulceration precluding identification of an intraepithelial dysplasia. Further, in many cases an invasive differentiated SCC is not identified. Adding to the complexity in such cases, is that immunohistochemical staining in a significant minority of cases is negative for epithelial-related markers but often the cells express mesenchymal-related markers. In such cases, differentiating SCSC from a reactive (benign) spindle cell proliferation or a mucosal-based sarcoma can be problematic, with treatment implications. Herein, we detail the clinical and pathologic features of laryngeal SCSC and discuss the rationale for diagnosing a carcinoma and avoiding a diagnosis of sarcoma. In our experience, such cases represent one of the more common mistakes made in laryngeal pathology. Yet, virtually all such lesions are SCSCs. The treatment and prognosis relies on the accuracy of this distinction. |
format | Online Article Text |
id | pubmed-8010031 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-80100312021-04-16 The Most Common Mistake in Laryngeal Pathology and How to Avoid it Heidarian, Amin Wenig, Bruce M. Head Neck Pathol Proceedings of the North American Society of Head and Neck Pathology, Baltimore, MD, March 17, 2021 Upper aerodigestive tract (UADT) spindle cell squamous carcinoma (SCSC), also known as sarcomatoid carcinoma, is a high-grade subtype of conventional squamous cell carcinoma (SCC) that is histologically characterized by a combination of differentiated SCC in the form of intraepithelial dysplasia and/or invasive differentiated SCC, and the presence of an invasive (submucosal) undifferentiated malignant spindle-shaped and pleomorphic (epithelioid) cell component. Typically, SCSC presents as a superficial polypoid mass not infrequently with surface ulceration precluding identification of an intraepithelial dysplasia. Further, in many cases an invasive differentiated SCC is not identified. Adding to the complexity in such cases, is that immunohistochemical staining in a significant minority of cases is negative for epithelial-related markers but often the cells express mesenchymal-related markers. In such cases, differentiating SCSC from a reactive (benign) spindle cell proliferation or a mucosal-based sarcoma can be problematic, with treatment implications. Herein, we detail the clinical and pathologic features of laryngeal SCSC and discuss the rationale for diagnosing a carcinoma and avoiding a diagnosis of sarcoma. In our experience, such cases represent one of the more common mistakes made in laryngeal pathology. Yet, virtually all such lesions are SCSCs. The treatment and prognosis relies on the accuracy of this distinction. Springer US 2021-03-15 /pmc/articles/PMC8010031/ /pubmed/33723761 http://dx.doi.org/10.1007/s12105-020-01273-6 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Proceedings of the North American Society of Head and Neck Pathology, Baltimore, MD, March 17, 2021 Heidarian, Amin Wenig, Bruce M. The Most Common Mistake in Laryngeal Pathology and How to Avoid it |
title |
The Most Common Mistake in Laryngeal Pathology and How to Avoid it |
title_full |
The Most Common Mistake in Laryngeal Pathology and How to Avoid it |
title_fullStr |
The Most Common Mistake in Laryngeal Pathology and How to Avoid it |
title_full_unstemmed |
The Most Common Mistake in Laryngeal Pathology and How to Avoid it |
title_short |
The Most Common Mistake in Laryngeal Pathology and How to Avoid it |
title_sort | most common mistake in laryngeal pathology and how to avoid it |
topic | Proceedings of the North American Society of Head and Neck Pathology, Baltimore, MD, March 17, 2021 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8010031/ https://www.ncbi.nlm.nih.gov/pubmed/33723761 http://dx.doi.org/10.1007/s12105-020-01273-6 |
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