Does pTis exist in HPV-driven tonsillar carcinomas? An ultrastructural review and examination of two cases

ABSTRACT

Many tonsillar tumors present clinically as cervical nodal metastases and the primary tumor is often difficult to find. HPV-driven tonsillar carcinoma begins in the reticulated crypt epithelium, possibly through viral integration. The basement membrane is not complete in the reticulated crypt epithelium, which may enhance the immune function. We examined the reticulated crypt epithelium in a normal case and five neoplastic tonsils with cervical metastasis as the presenting symptom to further investigate whether tonsil carcinoma in-situ exists. Our results suggest that in-situ carcinoma may need to be excluded from the future staging for human papilloma virus associated tonsillar tumors.

KEYWORDS:

• HPV tonsil
• in-situ tonsil carcinoma
• tonsil carcinoma
• tonsil carcinoma stage
• tonsil carcinoma ultrastructure

Acknowledgments

The authors presented part of this paper at the 2011 USCAP meeting, as a poster presentation.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing.