Cytopathologic characteristics of HPV-related small cell carcinoma of the oropharynx

Derek B. Allison, Lisa M. Rooper, Sara Mustafa, Zahra Maleki, Paul E. Wakely, Syed Z. Ali

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Human papillomavirus (HPV)–related squamous cell carcinoma (SqCC) of the oropharynx is an epidemiologically and clinically distinct form of SqCC that is associated with an improved prognosis. However, HPV-related small cell carcinoma of the oropharynx is a rare and newly described variant that is associated with aggressive clinical behavior and poor outcomes. To date, fewer than 2 dozen reports of this entity exist in the literature, and there is no discussion of cytopathologic features. This article reports 6 cases and discusses the salient cytomorphologic findings, ancillary studies, and challenges when this entity is encountered. Methods: Anatomic pathology archives were searched to identify patients with a diagnosis of HPV-related small cell carcinoma of the oropharynx. Medical records were reviewed to document the following: age, sex, smoking status, other relevant clinical history, primary location, treatment, and clinical outcome. Both p16 and high-risk HPV in situ hybridization (ISH) studies were positive in at least 1 specimen from each patient. The pathologic diagnoses, cytomorphologic characteristics, immunocytochemical stains, and HPV ISH studies were reviewed and recorded for all available cases. Results: Six patients with 11 cytopathology specimens of HPV-related small cell carcinoma of the oropharynx were identified. The mean age was 61.3 years, and all patients died with widely metastatic disease (mean, 23 months; range, 12-48 months). Mixed small cell carcinoma and SqCC components were present in half of the cases. Conclusions: The identification of a small cell component can be reliably performed with cytology preparations and is crucial because this (and not the HPV status) determines the prognosis.

Original languageEnglish (US)
Pages (from-to)35-43
Number of pages9
JournalCancer Cytopathology
Issue number1
StatePublished - Feb 2019


  • cytopathology
  • head and neck cancer
  • human papillomavirus
  • small cell carcinoma
  • squamous cell carcinoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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