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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Small Lymphocytic Lymphoma Obscuring Microscopic Tonsillar Squamous Cell Carcinoma: an Unknown Occurrence with a Known Primary</title>
<author><name sortKey="Minca, Eugen C" sort="Minca, Eugen C" uniqKey="Minca E" first="Eugen C." last="Minca">Eugen C. Minca</name>
<affiliation><nlm:aff id="Aff1">Department of Pathology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263 USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Popat, Saurin R" sort="Popat, Saurin R" uniqKey="Popat S" first="Saurin R." last="Popat">Saurin R. Popat</name>
<affiliation><nlm:aff id="Aff2">Department of Otolaryngology—Head and Neck Surgery, School of Medicine, State University of New York at Buffalo, Buffalo, NY 14214 USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Chadha, Manpreet K" sort="Chadha, Manpreet K" uniqKey="Chadha M" first="Manpreet K." last="Chadha">Manpreet K. Chadha</name>
<affiliation><nlm:aff id="Aff3">Virginia G. Piper Cancer Center/TGen, Scottsdale, AZ 85258 USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Merzianu, Mihai" sort="Merzianu, Mihai" uniqKey="Merzianu M" first="Mihai" last="Merzianu">Mihai Merzianu</name>
<affiliation><nlm:aff id="Aff1">Department of Pathology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263 USA</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">21120710</idno>
<idno type="pmc">3311942</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3311942</idno>
<idno type="RBID">PMC:3311942</idno>
<idno type="doi">10.1007/s12105-010-0228-9</idno>
<date when="2010">2010</date>
<idno type="wicri:Area/Pmc/Corpus">000A13</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000A13</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Small Lymphocytic Lymphoma Obscuring Microscopic Tonsillar Squamous Cell Carcinoma: an Unknown Occurrence with a Known Primary</title>
<author><name sortKey="Minca, Eugen C" sort="Minca, Eugen C" uniqKey="Minca E" first="Eugen C." last="Minca">Eugen C. Minca</name>
<affiliation><nlm:aff id="Aff1">Department of Pathology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263 USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Popat, Saurin R" sort="Popat, Saurin R" uniqKey="Popat S" first="Saurin R." last="Popat">Saurin R. Popat</name>
<affiliation><nlm:aff id="Aff2">Department of Otolaryngology—Head and Neck Surgery, School of Medicine, State University of New York at Buffalo, Buffalo, NY 14214 USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Chadha, Manpreet K" sort="Chadha, Manpreet K" uniqKey="Chadha M" first="Manpreet K." last="Chadha">Manpreet K. Chadha</name>
<affiliation><nlm:aff id="Aff3">Virginia G. Piper Cancer Center/TGen, Scottsdale, AZ 85258 USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Merzianu, Mihai" sort="Merzianu, Mihai" uniqKey="Merzianu M" first="Mihai" last="Merzianu">Mihai Merzianu</name>
<affiliation><nlm:aff id="Aff1">Department of Pathology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263 USA</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Head and Neck Pathology</title>
<idno type="ISSN">1936-055X</idno>
<idno type="eISSN">1936-0568</idno>
<imprint><date when="2010">2010</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p>Head and neck squamous cell carcinoma (HNSCC) often presents with cervical lymph node metastases and at times the primary tumor cannot be identified despite extensive workup. Lymphoma is the second most common neoplasm in the head and neck region but is seldom synchronous with HNSCC and rarely involves regional mucosal sites. We report herein a rare occurrence of tonsillar involvement by small lymphocytic lymphoma (SLL) incidentally detected during the workup for a cervical lymph node SCC metastasis of a 52-year-old non-smoker male. The microscopic human papillomavirus-positive SCC involving the tonsillar surface and crypts was obscured by SLL leading to the initial designation of ‘unknown primary’. The occult HNSCC are likely explained by small tumor size, quality and quantity of sampling, thoroughness of endoscopic, radiological and pathological assessment or a combination of the above. The coexistence of another tumor such as lymphoma has not yet been reported as a confounding factor in the workup for cervical SCC metastasis. Since oropharyngeal SCC can be very small and Waldeyer’s ring is a common site for lymphoma involvement, identification of such rare collision tumors requires pathologists’ awareness, extensive sampling and occasionally ancillary studies for the accurate diagnosis and staging essential for the correct management.</p>
</div>
</front>
</TEI>
<pmc article-type="case-report"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Head Neck Pathol</journal-id>
<journal-id journal-id-type="iso-abbrev">Head Neck Pathol</journal-id>
<journal-title-group><journal-title>Head and Neck Pathology</journal-title>
</journal-title-group>
<issn pub-type="ppub">1936-055X</issn>
<issn pub-type="epub">1936-0568</issn>
<publisher><publisher-name>Springer US</publisher-name>
<publisher-loc>Boston</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">21120710</article-id>
<article-id pub-id-type="pmc">3311942</article-id>
<article-id pub-id-type="publisher-id">228</article-id>
<article-id pub-id-type="doi">10.1007/s12105-010-0228-9</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject>
</subj-group>
</article-categories>
<title-group><article-title>Small Lymphocytic Lymphoma Obscuring Microscopic Tonsillar Squamous Cell Carcinoma: an Unknown Occurrence with a Known Primary</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Minca</surname>
<given-names>Eugen C.</given-names>
</name>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Popat</surname>
<given-names>Saurin R.</given-names>
</name>
<xref ref-type="aff" rid="Aff2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chadha</surname>
<given-names>Manpreet K.</given-names>
</name>
<xref ref-type="aff" rid="Aff3">3</xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Merzianu</surname>
<given-names>Mihai</given-names>
</name>
<address><phone>+716 845 7717</phone>
<fax>+716 845 3427</fax>
<email>mihai.merzianu@roswellpark.org</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<aff id="Aff1"><label>1</label>
Department of Pathology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263 USA</aff>
<aff id="Aff2"><label>2</label>
Department of Otolaryngology—Head and Neck Surgery, School of Medicine, State University of New York at Buffalo, Buffalo, NY 14214 USA</aff>
<aff id="Aff3"><label>3</label>
Virginia G. Piper Cancer Center/TGen, Scottsdale, AZ 85258 USA</aff>
</contrib-group>
<pub-date pub-type="epub"><day>1</day>
<month>12</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="collection"><month>3</month>
<year>2012</year>
</pub-date>
<volume>6</volume>
<issue>1</issue>
<fpage>125</fpage>
<lpage>129</lpage>
<history><date date-type="received"><day>30</day>
<month>9</month>
<year>2010</year>
</date>
<date date-type="accepted"><day>11</day>
<month>11</month>
<year>2010</year>
</date>
</history>
<permissions><copyright-statement>© Springer Science+Business Media, LLC 2010</copyright-statement>
</permissions>
<abstract id="Abs1"><p>Head and neck squamous cell carcinoma (HNSCC) often presents with cervical lymph node metastases and at times the primary tumor cannot be identified despite extensive workup. Lymphoma is the second most common neoplasm in the head and neck region but is seldom synchronous with HNSCC and rarely involves regional mucosal sites. We report herein a rare occurrence of tonsillar involvement by small lymphocytic lymphoma (SLL) incidentally detected during the workup for a cervical lymph node SCC metastasis of a 52-year-old non-smoker male. The microscopic human papillomavirus-positive SCC involving the tonsillar surface and crypts was obscured by SLL leading to the initial designation of ‘unknown primary’. The occult HNSCC are likely explained by small tumor size, quality and quantity of sampling, thoroughness of endoscopic, radiological and pathological assessment or a combination of the above. The coexistence of another tumor such as lymphoma has not yet been reported as a confounding factor in the workup for cervical SCC metastasis. Since oropharyngeal SCC can be very small and Waldeyer’s ring is a common site for lymphoma involvement, identification of such rare collision tumors requires pathologists’ awareness, extensive sampling and occasionally ancillary studies for the accurate diagnosis and staging essential for the correct management.</p>
</abstract>
<kwd-group><title>Keywords</title>
<kwd>Head and neck occult carcinoma</kwd>
<kwd>Tonsillar carcinoma</kwd>
<kwd>Small lymphocytic lymphoma</kwd>
<kwd>Collision tumor</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© Springer Science+Business Media, LLC 2012</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
</record>
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