Cory Bernadt
Washington University, USA
Title: Fine Needle Aspiration Biopsy of HPV-Related Squamous Cell Carcinomas of the Oropharynx
Biography
Biography: Cory Bernadt
Abstract
Human papilloma virus (HPV)-related oropharyngeal squamous cell carcinoma (SCC) is a unique form of carcinoma that is important to identify for prognosis and treatment. Patients with HPV-related oropharyngeal SCC have a much better prognosis and an enhanced response to radiation and chemotherapy compared to patients with conventional (HPV-negative) SCC of the head and neck. A significant proportion of patients with head and neck SCC present with neck masses as their first symptom. Fine-needle aspiration (FNA) of cervical lymph nodes is fast, easy to perform, minimally invasive, and accurate as a modality for the diagnosis of metastatic SCC. While morphologic features, particularly a non-keratinizing phenotype, strongly predict an association with HPV, ancillary studies are often used to confirm the diagnosis. A common and readily available modality is immunohistochemical staining for p16, an excellent surrogate marker for transcriptionally active, high-risk HPV. Even focal, strong and confluent p16 positive staining of FNA biopsy material correlates with high-risk HPV. Alternatively, high-risk HPV can be detected directly by RNA in-situ hybridization, and other molecular-based approaches, some of which are already routinely used in gynecologic cervical specimens. The objective of the presentation will be to discuss FNA of HPV-related oropharyngeal SCC, and to explore the different ancillary testing methods that are used to make the diagnosis.