Objective: To determine the reliability of identifying angiolymphatic invasion in histopathologic specimens of mobile tongue squamous cell carcinoma (SCCa). Introduction: Evidence of angiolymphatic invasion on histopathologic surgical specimens of head and neck SCCa is often regarded as an indicator for increased tumor aggressiveness and/or poorer prognosis. Adjuvant treatment (i.e. radiation therapy and/or chemotherapy) is oftentimes based in part on these findings. Trained head and neck pathologists, however, admit to sampling error of tissue specimens and, specifically, difficulty in definitively identifying angiolymphatic invasion, thereby, questioning the reliability of angiolymphatic invasion in certain histopathologic specimens. Methods: Retrospective chart review indentifying 15 patients with mobile tongue SCCa with evidence of "angiolymphatic invasion" on permanent histopathologic surgical specimen. Additional histologic sections were obtained from each patients' original tumor block for additional review for angiolymphatic invasion.
Results: To date, data collection from 6 of 15 patients has been completed. Two of 6 patients' histologic sections showed a change in the presence/absence of angiolymphatic invasion upon further review, while 4 of 6 patients showed no change. Conclusion: Evidence, or lack thereof, of angiolymphatic invasion on histologic section may lack reliability even when examined by trained head and neck pathologists. Further studies must be performed to determine if additional histopathologic tests are necessary to confirm such findings.
Results
To date, data collection from 6 of 15 patients has been completed. See Table I for results.
Upon review of the original slides from 6 patients, the accuracy of pathologic characteristics (i.e. presence of angiolymphatic invasion) was confirmed. Overall, 4 patients showed no change in angiolymphatic invasion characteristics upon re-sectioning, whereas two patients, patient 4 and 14, showed a change from positive to negative and from negative to positive, respectively.