CONTENTS

1. Anatomy, Histology, and Embryology ...... 1 Nasal Cavity...... 1 Anatomy...... 1 Histology ...... 2 Embryology ...... 4 Paranasal Sinuses ...... 5 Anatomy...... 5 Histology ...... 6 Oral Cavity ...... 6 Anatomy...... 6 Histology ...... 6 Pharynx...... 6 Anatomy...... 6 Histology ...... 7 Larynx ...... 8 Anatomy...... 8 Histology ...... 10 Embryology ...... 13 2. Staging of Head and Neck Carcinoma ...... 15 General Rules of Reporting...... 15 Histopathologic Grade ...... 16 Specific Anatomic Sites...... 16 Oral Cavity ...... 16 Pharynx...... 17 Larynx ...... 18 Nasal Cavity and Paranasal Sinuses ...... 19 Stage Grouping ...... 20 3. Benign Squamous Proliferations ...... 21 Squamous Papilloma ...... 21 Schneiderian Papillomas ...... 22 Inverted Schneiderian Papilloma...... 23 Exophytic Schneiderian Papilloma ...... 25 Oncocytic Schneiderian Papilloma ...... 29 Inverted Ductal Papilloma of Minor Salivary Glands...... 30 Papillomas of the Larynx and Trachea...... 33 Tumor-Like Lesions...... 36 Verrucous Hyperplasia...... 36

ix Tumors of the Upper Aerodigestive Tract and Ear

Pseudoepitheliomatous Hyperplasia ...... 38 Verruca Vulgaris of the Larynx and Oral Cavity...... 40 4. Conventional Squamous Cell Carcinoma...... 47 Keratosis...... 47 Dysplasia...... 48 Grading Systems...... 49 Invasive Squamous Cell Carcinoma...... 53 Microscopic Findings...... 53 Prognostic Indicators...... 55 Cytologic Findings ...... 56 Molecular Findings...... 58 Site-Specific Invasive Squamous Cell Carcinoma...... 59 Lip ...... 59 Oral Cavity (General)...... 60 Oral Tongue ...... 62 Nasal Cavity/Paranasal Sinuses ...... 63 Nasopharynx ...... 65 Oropharynx...... 66 Hypopharynx ...... 67 Larynx...... 67 5. Squamous Cell Carcinoma: Diagnostically Problematic Variants ...... 81 Verrucous Carcinoma ...... 81 Spindle Cell Carcinoma...... 87 Papillary Squamous Cell Carcinoma...... 95 Adenosquamous Carcinoma...... 98 Acantholytic (Adenoid and Angiosarcoma-Like) Squamous Cell Carcinoma ...... 103 Basaloid Squamous Cell Carcinoma...... 107 Undifferentiated Carcinomas...... 114 Epstein-Barr Virus-Associated Carcinoma ...... 114 Human Papillomavirus-Associated Carcinoma...... 123 NUT Midline Carcinoma...... 129 6. Glandular Neoplasms ...... 149 Adenocarcinoma (Nonsalivary Gland Types) ...... 149 Sinonasal Intestinal-Type Adenocarcinoma...... 149 Low-Grade Nonintestinal Adenocarcinoma ...... 156 High-Grade Nonintestinal Adenocarcinoma ...... 160 Other Adenocarcinomas...... 162 Respiratory Epithelial Adenomatoid (and Seromucinous) Hamartomas...... 162 Sinonasal Ameloblastoma ...... 167

 Contents

7. Neural, Neuroendocrine, and Neuroectoderma Neoplasia...... 173 Heterotopic Glial Tissue (Nasal Glioma) ...... 173 Ectopic Pituitary Tissue and Pituitary Adenoma...... 176 Neurofibroma ...... 177 Neuromas...... 181 Palisaded Encapsulated Neuroma (Solitary Circumscribed Neuroma) ...... 181 Traumatic Neuroma...... 182 Mucosal Neuroma (Ganglioneuroma) ...... 182 Neurilemoma (Schwannoma) ...... 184 Neurothekeoma ...... 188 Melanotic Neuroectodermal Tumor of Infancy ...... 188 Granular Cell Tumor/Congenital Epulis ...... 191 Craniopharyngioma ...... 197 Meningioma ...... 198 Olfactory Neuroblastoma ...... 201 Sinonasal Undifferentiated Carcinoma...... 212 Carcinoid Tumor and Moderately Differentiated Neuroendocrine Carcinoma (Atypical Carcinoid Tumor) ...... 219 Small Cell Carcinoma...... 227 Malignant Melanoma...... 232 Peripheral Neuroectodermal Tumor/Extraosseous Ewing Sarcoma ...... 240 8. Hematopoietic and Lymphoid Disorders...... 261 Tonsillitis and Reactive Hyperplasia, Not Otherwise Specified...... 263 Infectious Mononucleosis ...... 264 Hyperplasia of Waldeyer Ring in Human Immunodeficiency Virus Infection...... 267 Sinus Histiocytosis with Massive Lymphadenopathy...... 269 Mature B-Cell Neoplasms (Excluding Plasmacytoma)...... 272 Mature T- and NK-Cell Malignancies (Excluding NT-/T-Cell Lymphoma, Nasal Type) . 280 Extranodal NK-/T-Cell Lymphoma, Nasal Type ...... 283 Precursor Lymphoid Neoplasms...... 291 Extraosseous Plasmacytoma ...... 292 Myeloid Sarcoma ...... 297 Histiocytic and Dendritic Cell Neoplasms ...... 300 Immunodeficiency-Associated Lymphoproliferative Disorders...... 303 Hodgkin Lymphoma ...... 306 9. Vascular Lesions Predilecting the Head and Neck ...... 323 Lobular Capillary Hemangioma...... 323 Glomangiopericytoma (Sinonasal Hemangiopericytoma), Glomus Tumor, and Other Tumors with Perivascular Myoid Differentiation...... 327

xi Tumors of the Upper Aerodigestive Tract and Ear

Nasopharyngeal Angiofibroma ...... 330 Laryngeal Hemangioma ...... 339 Infantile Hemangioma ...... 339 Adult Hemangioma ...... 340 Polypoid Granulation Tissue...... 342 Lymphangioma (Cystic Hygroma)...... 344 Kaposi Sarcoma...... 345 Angiosarcoma ...... 346 Bacillary Angiomatosis ...... 347 10. Fibroblastic and Myofibroblastic Tumors...... 353 Fibroma...... 354 Solitary Fibrous Tumor ...... 355 Aggressive Fibromatosis...... 357 Myofibroma/Myofibromatosis ...... 361 Nodular Fasciitis ...... 362 Inflammatory Myofibroblastic Tumor...... 363 Fibrosarcoma...... 367 Low-Grade Myofibroblastic Sarcoma ...... 370 Undifferentiated Pleomorphic Sarcoma...... 371 11. Osseous Lesions Predilecting the Head and Neck...... 381 Osteoma...... 381 Osteosarcoma ...... 383 Osteosarcoma of the Jaw ...... 383 Osteosarcoma of the Extragnathic Bones ...... 386 Sarcomas Arising in Paget Disease...... 387 Postradiation Sarcomas ...... 387 Chordoma...... 389 Chondroid Chordoma...... 392 Differentiated Chordoma...... 393 Eosinophilic Granuloma (Langerhans Cell Histiocytosis) ...... 394 Giant Cell Granuloma...... 397 Fibrous Dysplasia...... 400 Ossifying Fibroma...... 403 12. Miscellaneous Soft Tissue Neoplasms...... 411 Lipoma...... 411 Liposarcoma...... 413 Leiomyoma...... 414 Leiomyosarcoma...... 416 Chondroma ...... 418 Chondrosarcoma ...... 421

xii Contents

Ectomesenchymal Chondromyxoid Tumor...... 423 Chondromesenchymal Hamartoma ...... 426 Mesenchymal Chondrosarcoma...... 427 Myxoid Chondrosarcoma...... 429 Rhabdomyoma ...... 430 Rhabdomyosarcoma ...... 436 Ossifying Fibromyxoid Tumor ...... 441 Synovial Sarcoma...... 442 Alveolar Soft Part Sarcoma ...... 444 13. Germ Cell Neoplasms...... 455 Teratoma...... 455 Teratocarcinosarcoma...... 458 Yolk-Sac Tumor (Endodermal Sinus Tumor)...... 461 Choriocarcinoma...... 461 14. Metastatic Neoplasms...... 465 15. Miscellaneous Tumor-Like Lesions...... 469 Nasal Polyp ...... 469 Antrochoanal Polyp...... 472 Vocal Cord Nodule/Polyp...... 474 Contact/Postintubation Ulcer of the Larynx ...... 476 Dermoid Cyst...... 477 Hairy Polyp...... 479 Amyloid Deposition ...... 479 Laryngeal Rheumatoid Arthritis and Nodules ...... 481 Rhinoscleroma...... 482 Rhinosporidiosis ...... 484 Laryngocele/Laryngeal Cyst ...... 485 Laryngocele ...... 485 Laryngeal Cysts...... 485 Median Rhomboid Glossitis ...... 486 Juxtaoral Organ of Chievitz ...... 487 Necrotizing Sialometaplasia ...... 488 Teflon Granuloma (“Teflonoma”)...... 491 Myospherulosis...... 492 16. Tumors of the Ear ...... 499 Anatomy ...... 499 Embryology ...... 500 Histology...... 501 Tumor-Like Lesions and Neoplasms of the External Ear and Auditory Canal ...... 504 Chondrodermatitis Nodularis Chronica Helicis ...... 504

xiii Tumors of the Upper Aerodigestive Tract and Ear

Keratosis Obturans, External Ear Cholesteatoma, and Keratin Granulomas ...... 506 Angiolymphoid Hyperplasia with Eosinophilia ...... 508 Accessory Tragus...... 511 Keloid...... 511 Osteoma and Exostosis...... 512 Idiopathic Cystic Chondromalacia ...... 514 Branchial Cleft Anomalies...... 515 Ceruminal Gland Adenoma ...... 517 Ceruminal Gland Pleomorphic Adenoma...... 520 Ceruminal Gland Syringocystadenoma Papilliferum ...... 521 Seborrheic Keratosis...... 522 Squamous Cell Papilloma...... 525 Atypical Fibroxanthoma...... 525 Ceruminal Gland Adenocarcinoma ...... 526 Ceruminal Gland Adenoid Cystic Carcinoma ...... 528 Basal Cell Carcinoma of the External Ear ...... 531 Squamous Cell Carcinoma of the External and Middle Ear ...... 533 Malignant Melanoma...... 537 Tumor-Like Lesions and Neoplasms of the Middle Ear...... 539 Inflammatory (Aural) Polyp ...... 539 Cholesteatoma...... 540 Choristoma...... 542 Jugulotympanic Paraganglioma...... 544 Middle Ear Adenoma...... 549 Schneiderian-Type (Inverted) Papilloma...... 552 Aggressive Papillary Tumor of Temporal Bone and Endolymphatic Sac ...... 554 Meningioma of Temporal Bone...... 557 Neoplasms Metastatic to the Middle Ear ...... 559 Rhabdomyosarcoma...... 559 Index ...... 571

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