{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:50:22Z","timestamp":1771462222988,"version":"3.50.1"},"reference-count":58,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,1,13]],"date-time":"2016-01-13T00:00:00Z","timestamp":1452643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Although HPV\u2010related head and neck squamous cell carcinoma (HNSCC) has good prognosis, a small proportion of patients develop distant metastases and have worse outcomes. Such metastases can be particularly difficult to diagnose in the lung and mediastinum, where they show extensive morphologic overlap with primary pulmonary neoplasms. This case series discusses metastatic HPV\u2010related HNSCC in lung and mediastinal fine needle aspiration (FNA) cytology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The cytopathology archives were searched for lung and mediastinal FNA specimens of patients with HNSCC. Specimens were included if either the index FNA or the patient's original HNSCC was positive for HPV by DNA in\u2010situ hybridization (ISH). Ten such cases were identified. Patient demographics and primary tumor details were tabulated from the electronic medical record. All FNA slides and stains were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The ten patients (mean age of 58.2 years) included 4 smokers. Smears from all cases were hypercellular and hyperchromatic, with focal keratinization in 6\/10 (60%). Core biopsies and cell blocks showed basaloid morphology with variable amounts of necrosis. All ten FNAs were diffusely positive for p16 (100%) and 7\/9 cases stained (77.8%) were positive for HPV DNA ISH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Metastatic HPV\u2010related HNSCC to the lung and mediastinal lymph nodes share the characteristic basaloid, minimally keratinizing morphology seen in Primary HNSCC cytology. Poorly differentiated pulmonary squamous cell carcinoma and neuroendocrine carcinomas are the primary differentials. Although primary lung neoplasms are not HPV\u2010related, p16 positivity can be seen in both squamous cell and small cell lung carcinomas. HPV ISH allows definitive diagnosis of metastatic HPV\u2010related HNSCC. Diagn. Cytopathol. 2016;44:206\u2013214. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dc.23425","type":"journal-article","created":{"date-parts":[[2016,1,14]],"date-time":"2016-01-14T08:59:25Z","timestamp":1452761965000},"page":"206-214","source":"Crossref","is-referenced-by-count":8,"title":["Metastatic <scp>HPV<\/scp>\u2010related head and neck squamous cell carcinoma to the lung and mediastinal lymph nodes in aspirated cytology material: A diagnostic pitfall"],"prefix":"10.1002","volume":"44","author":[{"given":"Natalie","family":"Banet","sequence":"first","affiliation":[{"name":"Department of Pathology the Johns Hopkins University School of Medicine Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa M.","family":"Rooper","sequence":"additional","affiliation":[{"name":"Department of Pathology the Johns Hopkins University School of Medicine Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahra","family":"Maleki","sequence":"additional","affiliation":[{"name":"Department of Pathology the Johns Hopkins University School of Medicine Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,1,13]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31813e5fbb"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/92.9.709"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-009-0100-y"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-014-0528-6"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2012.04.001"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminoncol.2004.09.011"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.11633"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912217"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn011"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20010815)92:4<805::AID-CNCR1386>3.0.CO;2-9"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0215(20000520)89:3<300::AID-IJC14>3.0.CO;2-G"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.11.025"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.00.3335"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.08.031"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.44.0164"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2012.07.015"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.04.006"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-012-0355-6"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3182395c7b"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-013-1075-9"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-06-1690"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1159\/000375148"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25033"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-013-0509-1"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.50.0231"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2009.11.004"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23014"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.22837"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21027"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31816380ec"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-009-0126-1"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.pas.0000173240.63073.fe"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000183"},{"key":"e_1_2_5_35_1","first-page":"3085","article-title":"Human papillomavirus DNA and p16 gene in squamous cell lung carcinoma","volume":"32","author":"Gatta LB","year":"2012","journal-title":"Anticancer Res"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1165\/ajrcmb.18.2.3033"},{"key":"e_1_2_5_37_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1995.69"},{"key":"e_1_2_5_38_1","first-page":"610","article-title":"Detection of human papillomavirus types 16, 18 DNA related sequences in bronchogenic carcinoma by polymerase chain reaction","volume":"108","author":"Li Q","year":"1995","journal-title":"Chin Med J (Engl)"},{"key":"e_1_2_5_39_1","first-page":"1093","article-title":"Detection of human papillomavirus DNA in primary lung carcinoma by nested polymerase chain reaction","volume":"41","author":"Thomas P","year":"1995","journal-title":"Cell Mol Biol (Noisy\u2010le\u2010Grand)"},{"key":"e_1_2_5_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/carcin\/bgp177"},{"key":"e_1_2_5_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.21351"},{"key":"e_1_2_5_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2014.12.012"},{"key":"e_1_2_5_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3182299cde"},{"key":"e_1_2_5_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31823f2f17"},{"key":"e_1_2_5_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318290427d"},{"key":"e_1_2_5_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181b6d8e6"},{"key":"e_1_2_5_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-011-0245-3"},{"key":"e_1_2_5_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3182a0218f"},{"key":"e_1_2_5_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21462"},{"key":"e_1_2_5_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318265fb2b"},{"key":"e_1_2_5_51_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181e84652"},{"key":"e_1_2_5_52_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-11-0388"},{"key":"e_1_2_5_53_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318253a2d1"},{"key":"e_1_2_5_54_1","first-page":"505","article-title":"Reciprocal Rb inactivation and p16INK4 expression in primary lung cancers and cell lines","volume":"55","author":"Shapiro GI","year":"1995","journal-title":"Cancer Res"},{"key":"e_1_2_5_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2014.02.011"},{"key":"e_1_2_5_56_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-011-0282-y"},{"key":"e_1_2_5_57_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2011.91"},{"key":"e_1_2_5_58_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAI.0b013e318215248a"},{"key":"e_1_2_5_59_1","first-page":"328","article-title":"Transcriptionally active human papillomavirus is detected by RNA in situ hybridization in most discordant oropharyngeal squamous cell carcinomas that are P16 positive by immunohistochemistry but high risk HPV negative by DNA in situ hybridization","volume":"28","author":"Rooper L","year":"2015","journal-title":"Mod Pathol"}],"container-title":["Diagnostic Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fdc.23425","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.23425","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T15:53:21Z","timestamp":1695570801000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dc.23425"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1,13]]},"references-count":58,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2016,3]]}},"alternative-id":["10.1002\/dc.23425"],"URL":"https:\/\/doi.org\/10.1002\/dc.23425","archive":["Portico"],"relation":{},"ISSN":["8755-1039","1097-0339"],"issn-type":[{"value":"8755-1039","type":"print"},{"value":"1097-0339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,1,13]]}}}