title: Ciliated Adenosquamous Carcinoma: Expanding the Phenotypic Diversity of Human Papillomavirus-Associated Tumors.
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.
authors.affiliation: Department of Pathology and Laboratory Medicine, Presbyterian-Shadyside Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, 15232, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Radkay-Gonzalez
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, MA, 02114, USA.
authors.forename: William
authors.initials: W
authors.lastname: Faquin
authors.affiliation: Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: McHugh
authors.affiliation: Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, 63110, USA.|Department of Pathology, Microbiology and Immunology, Vanderbilt University, Nashville, TN, 37232, USA.
authors.forename: James S
authors.initials: JS
authors.lastname: Lewis
authors.affiliation: Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA, 19107, USA.
authors.forename: Madalina
authors.initials: M
authors.lastname: Tuluc
authors.affiliation: Department of Pathology and Laboratory Medicine, Presbyterian-Shadyside Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, 15232, USA. seethalarr@upmc.edu.|A614.X Presbyterian University Hospital, 200 Lothrop St, Pittsburgh, PA, 15213, USA. seethalarr@upmc.edu.
authors.forename: Raja R
authors.identifier: http://orcid.org/0000-0003-3617-075X
authors.initials: RR
authors.lastname: Seethala
mesh_terms: D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000473:pathology* / Q000821:virology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000821:virology*; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications*; D010641:Phenotype
keywords: Adenosquamous; Ciliated; Human papillomavirus; MAML2; Non-keratinizing