By Edward B Stelow MD, Stacey Mills
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Extra resources for Biopsy Interpretation of the Upper Aerodigestive Tract and Ear
35 Squamous Cell Hyperplasia Squamous cell hyperplasia is the most common cause of leukoplakia and is considered to be an epithelial precursor lesion by the WHO (Fig. 2, e-Fig. 1). It is characterized by increased epithelial thickness and, often, associated keratosis. The cellular proliferation may be located uniformly throughout the epithelium or appear localized to specific zones. By definition, there should be no architectural or cytologic atypia. Although considered to be a precursor lesion to squamous cell carcinoma, the risk for the eventual development of malignancy in patients with only this lesion is very low.
Conventional Squamous Cell Carcinoma ——— 55 esmoplasia may also be helpful. Often, at least microinvasive disease can d be appreciated. As with the previous dilemma, pathologists may be forced in these situations to render descriptive diagnoses. Here, the danger often lies with overinterpretation and a possible false-positive diagnosis. In the absence of definitive invasion, descriptive diagnoses are assuredly preferred. Radiation therapy remains a standard treatment modality for head and neck SCC.
These cells often show artifactual separation from one another, and intercellular desmosomes can typically be identified. Within the cytoplasm of the larger, differentiated cells, intracellular keratin formation and granules can sometimes be seen. The nuclei of the neoplastic cells show moderate to marked differences in shape and size, with irregular contours and vesicular to granular, malignant-appearing chromatin. Prominent nucleoli are usually seen and mitotic figures, including atypical mitotic figures, can usually be found.