International Consensus Recommendations of Diagnostic Criteria and Terminologies for Extranodal Extension in Head and Neck Squamous Cell Carcinoma: An HN CLEAR Initiative (Update 1)

被引：0

作者：

Gupta, Ruta ^{[1
,2
,3
,21
,22
]}

Fielder, Timothy ^{[1
]}

Bal, Munita ^{[4
]}

Chiosea, Simion I. ^{[5
]}

Dahlstrom, Jane E. ^{[6
,7
]}

Kakkar, Aanchal ^{[8
]}

Kiss, Katalin ^{[9
]}

Laco, Jan ^{[10
,11
]}

Mittal, Neha ^{[4
]}

Pasricha, Sunil ^{[12
]}

Samra, Spinder ^{[13
]}

Zidar, Nina ^{[14
]}

Bullock, Martin ^{[15
]}

Chernock, Rebecca ^{[16
]}

Faquin, William ^{[17
]}

Huang, Shao Hui ^{[18
]}

Yang, Jean ^{[19
]}

Yoon, Sun Och ^{[20
]}

机构：

[1] Royal Prince Alfred Hosp, Dept Tissue Pathol & Diagnost Oncol, NSW Hlth Pathol, Sydney, NSW, Australia

[2] Univ Sydney, Fac Med & Hlth, Sydney, NSW, Australia

[3] Univ Sydney, Sydney, NSW, Australia

[4] Homi Bhabha Natl Inst, Tata Mem Ctr, Dept Pathol, Mumbai, Maharashtra, India

[5] Univ Pittsburgh, Dept Pathol, Pittsburgh, PA USA

[6] Canberra Hlth Serv, ACT Pathol, Canberra, Australia

[7] Australian Natl Univ, Coll Hlth & Med, Canberra, Australia

[8] All India Inst Med Sci, Dept Pathol, New Delhi, India

[9] Copenhagen Univ Hosp, Dept Pathol, Rigshosp, Copenhagen, Denmark

[10] Univ Hosp Hradec Kralove, Fingerland Dept Pathol, Hradec Kralove, Czech Republic

[11] Charles Univ Prague, Fac Med, Fac Med Hradec Kralove, Hradec Kralove 50005, Czech Republic

[12] Rajiv Gandhi Canc Inst & Res Ctr, Dept Pathol, New Delhi, India

[13] Westmead Hosp, Dept Pathol, NSW Hlth Pathol, Sydney, NSW, Australia

[14] Univ Ljubljana, Inst Pathol, Fac Med, Ljubljana, Slovenia

[15] Dalhousie Univ, Fac Med, Dept Pathol, Halifax, NS, Canada

[16] Washington Univ, Sch Med, Dept Pathol & Immunol, St Louis, MO USA

[17] Harvard Med Sch, Massachusetts Gen Hosp, Dept Pathol, Boston, MA USA

[18] Univ Toronto, Princess Margaret Canc Ctr, Dept Radiat Oncol, Toronto, ON, Canada

[19] Univ Sydney, Dept Math & Stat, Sydney, Australia

[20] Yonsei Univ, Coll Med, Severance Hosp, Dept Pathol, Seoul, South Korea

[21] Royal Prince Alfred Hosp, Tissue Pathol & Diagnost Oncol, NSW Hlth Pathol, Bldg 12,Missenden Rd, Camperdown, NSW 2050, Australia

[22] Univ Sydney, Cent Clin Sch, Royal Prince Alfred Hosp, Bldg 12,Missenden Rd, Camperdown, NSW 2050, Australia

来源：

HEAD & NECK PATHOLOGY | 2025年 / 19卷 / 01期

关键词：

Diagnosis; Extranodal extension (ENE); Histology; Lymph node; Head and neck; Macroscopy; Matting; Soft tissue deposit; Squamous cell carcinoma; EXTRACAPSULAR SPREAD; RADIATION-THERAPY; TRIAL;

D O I：

10.1007/s12105-025-01753-7

中图分类号：

R36 [病理学];

学科分类号：

100104 ;

摘要：

PurposeExtranodal extension (ENE) increases the risk of recurrence and death in head and neck squamous cell carcinoma (HNSCC) patients and is an indication for treatment escalation. Histopathology forms the mainstay of diagnosing ENE. There is substantial variation in the diagnosis of ENE and related terminology. Harmonising the diagnostic criteria for ENE was identified as a priority by the Head and Neck Consensus Language for Ease of Reproducibility (HN CLEAR) Steering Committee and its global stakeholders. MethodsAn international working group including 16 head and neck pathologists from eight countries across five continents evaluated whole slide images of haematoxylin and eosin-stained sections depicting potential diagnostic problems through nine virtual meetings to develop consensus guidelines. ResultsENE should be diagnosed only when viable carcinoma extends through the primary lymph node (LN) capsule and directly interacts with the extranodal host environment with or without desmoplastic stromal response. Identifying the original LN capsule and reconstruction of its contour can assist in the detection and assessment of ENE. The term matting is recommended for confluence of two or more nodes due to histologically identifiable tumour extending from one LN to another. Matting constitutes major form of ENE. On the other hand, the terms fusion/adhesion/confluence/conglomeration and other synonyms of adhesion should be limited to confluence due to fibrosis or inflammation without histologically identifiable tumour between involved lymph nodes. Tumour extension along narrow needle tracks or spillage of cyst contents following an FNA do not constitute ENE. ConclusionsThe consensus recommendations encompassing the definition of ENE, macroscopic and histologic examination of lymph nodes (LN) and practical guidelines for handling challenging cases are provided.

引用

页数：11

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