{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:52:10Z","timestamp":1787169130714,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,11,26]],"date-time":"2018-11-26T00:00:00Z","timestamp":1543190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The majority of human papillomavirus (HPV)\u2013associated oropharyngeal carcinomas are squamous cell carcinomas; however, there are rare reports of HPV\u2013associated neuroendocrine carcinomas (HPV\u2010NECs) in the upper aerodigestive tract. The aim of this study was to characterize the diagnostic features of fine\u2010needle aspiration (FNA) cases of head and neck HPV\u2010NEC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cytology cases of HPV\u2010NEC were identified over a 3\u2010year period from 2 institutions. Clinical, cytomorphologic, and ancillary test results were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five FNA cases of HPV\u2010NEC were identified from 4 patients with cervical lymph node metastases with primaries in the oropharynx (n = 2), nasopharynx (n = 1), and larynx (n = 1). Three cases showed mixed small cell and large cell neuroendocrine morphologies; 1 case was a small cell carcinoma, and the last case appeared as a large cell neuroendocrine carcinoma. All tumors were strongly positive for synaptophysin and p16 and negative for p63\/p40. Two cases tested for INSM1 showed diffuse nuclear staining. HPV was confirmed by in situ hybridization in 4 cases, and HPV\u201018 was detected by polymerase chain reaction in the fifth case. Retinoblastoma (Rb) staining was moderate to weak (5\/5), and p53 was weakly positive (5\/5).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Head and neck HPV\u2010NEC is a rare, aggressive entity that can show mixed small and large cell features and p16 upregulation; p53 and Rb are variable with limited diagnostic utility. Because p16 positivity can be nonspecific, confirmatory HPV testing is required and may be helpful in determining the primary site for neuroendocrine carcinoma of an unknown primary. The accurate diagnosis of HPV\u2010NEC is also important because of its worse prognosis in comparison with HPV\u2010associated squamous cell carcinoma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncy.22075","type":"journal-article","created":{"date-parts":[[2018,11,26]],"date-time":"2018-11-26T08:45:34Z","timestamp":1543221934000},"page":"26-34","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["HPV\u2010associated neuroendocrine carcinomas of the head and neck in FNA biopsies: Clinicopathologic features of a rare entity"],"prefix":"10.1002","volume":"127","author":[{"given":"Vickie Y.","family":"Jo","sequence":"first","affiliation":[{"name":"Department of Pathology Brigham and Women\u2019s Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey F.","family":"Krane","sequence":"additional","affiliation":[{"name":"Department of Pathology Brigham and Women\u2019s Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liron","family":"Pantanowitz","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara E.","family":"Monaco","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11,26]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"WHO Classification of Tumours: Pathology and Genetics of Head and Neck Tumours","author":"El\u2010Naggar 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