Indications of head and neck cytology

The head and neck region shows the presence of many organs, many different kinds of tissues, many different cell types in each organ and tissue.

What do we mean by 'head and neck' tumors or head and neck pathology?

• In general: lesions or tumors of the inner body surface in the region.
• In particular: nasal, paranasal, nasopharyngeal, hypopharyngeal, laryngo-tracheal, oral cavity,  oropharyngeal, salivary glands related, odontogenic, ear lesions (WHO 2005).
• Everything which may occur on this circumscribed anatomic area: see above, +: vascular tumors, lympoma, skin tumors, adnexal tumors, lachrymal gland lesions, thyroid.

What is characteristic in tumor pathology of head and neck?

• The anatomical region
• There are significant geographical characteristics of some of these lesions (nasopharyngeal carcinoma)
• Environmental influence is important
• Viruses in the development of cancer (HPV, EBV)
• Distant metastases are rare, local complications are severe

Main diagnostic questions

• What kind of tissue was aspirated?

In case the sampling is performed by the cytopathologist the answer is simple. In case of transported smears we always need to know all of the important clinical data, symptoms and the way of sampling.

• What do the general cellular features of the smear tell us? Is it a benign or malignant lesion?
  

Cystic lesions and fluid containing squamous cells may equally represent a squamous (lateral) cyst or a colliquated necrotic squamous cell carcinoma. Malignancies can be either primary or metastatic. Cellular pleomorphism is characteristic in mixed salivary gland tumors, which are nearly always benign, whereas a slightly atypical homogeneous cell population may be characteristic of acinic cell cancer or even adenoid cystic carcinoma.