PMC4239125_01
(A) Haematoxylin and eosin (H&E) stain of the neck nodal mass showing nonkeratinized squamous cell carcinoma (x200) in 2000. (B) Strong and diffuse p16 IHC stain of the tumour present in cervical lymph node from 2000.
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figure1
Biopsies of the neck nodal mass (Figure 1A) and the base-of-tongue mass revealed non-keratinizing type SCC on haematoxylin and eosin (H&E) stain (x200), a distinct morphologic type that characterizes HPV-related OPSCC. An immunohistochemistry stain (IHC) for p16, a known surrogate marker of HPV, was positive (Figure 1B).
FDG-PET from 2011 showing multiple FDG avid osseous metastatic lesions.
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figure2
Bone and CT scans revealed findings consistent with metastatic osseous lesions, which were confirmed on a fluorodeoxyglucose (FDG)-PET/CT scan (Figure 2).
(A) Intraosseous metastasis of nonkeratinizing squamous cell carcinoma in 2011 (H&E x100), (B) p16 IHC stain of the bone metastasis from 2011, and (C) High-risk HPV ISH of the bone metastasis from 2011 showing positive intranuclear blue stain.
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figure3
A bone marrow biopsy revealed non-keratinizing SCC on H&E stain (Figure 3A) that was morphologically similar to the OPSCC from 2000 and that was positive for p16 by IHC (Figure 3B) and for HPV by in situ hybridization (ISH) for high-risk HPV (Figure 3C).