The most important news in head and neck pathology published since the release of the 5th edition of the WHO Classification of Head and Neck Tumors
Authors:
Jan Laco 1,2; Martina Bradová 3,4; Alena Skálová 3,4
Authors‘ workplace:
Fingerlandův ústav patologie, Lékařská fakulta Univerzity Karlovy v Hradci Králové, Hradec Králové
1; Fingerlandův ústav patologie, Fakultní nemocnice Hradec Králové, Hradec Králové
2; Šiklův ústav patologie, Lékařská fakulta Univerzity Karlovy v Plzni, Plzeň
3; Bioptická laboratoř, s. r. o., Plzeň
4
Published in:
Čes.-slov. Patol., 62, 2026, No. 2, p. 96-105
Category:
Reviews Article
Overview
The review article describes the most important news in head and neck pathology, that were published in the period 2021–2025, and that are only marginally mentioned or not mentioned at all in the WHO Classification of Head and Neck Tumors 2024, the 5th edition. The article focuses solely on the pathology of the salivary glands and sinonasal tract and deals only with malignant tumors. Regarding salivary gland pathology; palisading adenocarcinoma, microcribriform adenocarcinoma, mucoacinar carcinoma, mucoepidermoid carcinoma devoid of morphologically distinct squamous cell differentiation, metatypical adenoid cystic carcinoma, adenoid cystic carcinoma with striking tubular hypereosinophilia, and new proposals for a grading system for acinic cell carcinoma and secretory carcinoma are discussed. Regarding pathology of the sinonasal tract; olfactory carcinoma and IDH2-mutated sinonasal carcinoma are mentioned.
Keywords:
review – salivary glands – news – head and neck pathology – sinonasal tract
Sources
1. WHO Classification of Tumours Editorial Board. Head and Neck Tumours. Lyon (France): International Agency for Research on Cancer; 2023. (WHO classification of tumours series, 5th ed.; vol. 9). https://publications. iarc.who.int/629.
2. Bishop JA, Weinreb I, van Vliet C, et al. Palisading adenocarcinoma: a morphologically unique salivary gland tumor with a neuroendocrine-like appearance and a predilection for the sublingual glands of women. Am J Surg Pathol 2023; 47(10): 1176-1185.
3. Dababneh MN, Griffith CC, Ooms K. Palisading adenocarcinoma. Head Neck Pathol 2024; 18(1): 80.
4. Manini C, Provenza C, Suriani A, Montemagno A, Vergano R, López JI. Palisading adenocarcinoma. Case report on a newly recognized tumor in the salivary glands. Pathol Res Pract 2024; 253 : 155088.
5. Zhang X, Bishop JA, Yang C, Yang Y, Cui J, Liu M. Palisading adenocarcinoma: several new inherited cases in six patients of a familial cohort. Head Neck Pathol 2025; 19(1): 86.
6. Bishop JA, Weinreb I, Swanson D, et al. Microsecretory adenocarcinoma: a novel salivary gland tumor characterized by a recurrent MEF2C-SS18 fusion. Am J Surg Pathol 2019; 43(8) :1023-1032.
7. Weinreb I, Hahn E, Dickson BC, et al. Microcribriform adenocarcinoma of salivary glands. A unique tumor entity characterized by an SS18::ZBTB7A fusion. Am J Surg Pathol 2023; 47(2): 194-201.
8. Bundele M, Weinreb I, Xu B, et al. Mucoacinar carcinoma – a rare variant of mucoepidermoid carcinoma. Am J Surg Pathol 2021; 45(8): 1028-1037.
9. Shah AA, Seethala RR. Squamoglandular variant of acinic cell carcinoma: a case report of a novel variant. Head Neck Pathol 2022; 16(3): 870-875.
10. Ramal R, Batson B, Spector ME, Chiosea SI, Seethala RR. Acinic cell carcinoma with high-grade squamoglandular and chondrosarcomatous transformation mimicking carcinosarcoma ex pleomorphic adenoma: a wrinkle in the proposed nomenclature revision for sarcomatoid salivary gland neoplasms. Head Neck Pathol 2024; 18(1): 44.
11. Nakano S, Okumura Y, Murase T, et al. Salivary mucoepidermoid carcinoma: histological variants, grading systems, CRTC1/3-MAML2 fusions, and clinicopathological features. Histopathology 2022; 80(4): 729-735.
12. Bishop JA, Thompson LDR, Siegele B, et al. Mucoepidermoid carcinoma may be devoid of squamoid cells by immunohistochemistry: expanding the histologic and immunohistochemical spectrum of MAML2-rearranged salivary gland tumours. Histopathology 2023; 82(2): 305-313.
13. Anh B, Choi SH, Kim D, Kim D, Cho KJ. Salivary gland neoplasms with a unique trabeculae histology and MAML2 translocation: a trabecular variant of mucoepidermoid carcinoma. Am J Surg Pathol 2023; 47(10): 1085 - 1095.
14. Mathew EP, Todorovic E, Truong T, et al. Metatypical adenoid cystic carcinoma: a variant showing prominent squamous differentiation with a predilection for the sinonasal tract and skull base. Am J Surg Pathol 2022; 46(6): 816-822.
15. Ooms KDW, Chiosea S, Lamarre E, Shah AA. Sebaceous differentiation as another feature of metatypical adenoid cystic carcinoma: a case report and letter to the editor. Am J Surg Pathol 2023; 47(1): 145-146.
16. Sedassari BT, Mota ME, Lascane NAS. Metatypical adenoid cystic carcinoma of the palate. Head Neck Pathol 2025; 19(1): 59.
17. Skálová A, Bradová M, Agaimy A, et al. Molecular profiling of sinonasal adenoid cystic carcinoma: canonical and noncanonical gene fusions and mutation. Am J Surg Pathol 2025; 49(3): 227-242.
18. Weinreb I, Rooper LM, Dickson BC, et al. Adenoid cystic carcinoma with striking tubular hypereosinophilia: a unique pattern associated with nonparotid location and both canonical and novel EWSR1::MYB and FUS::MYB fusions. Am J Surg Pathol 2023; 47(4): 497-503.
19. Yadav U, Mahendru R., Sharma J, Kakkar A. Diagnosis of adenoid cystic carcinoma with striking tubular hypereosinophilia by MYB and EWSR1 breakapart fluorescence in situ hybridization. Head Neck Pathol 2023; 14(4): 940-951.
20. Bradová M, Agaimy A, Laco J, et al. Sinonasal adenoid cystic carcinomas accompanied by seromucinous hamartoma and/or atypical sinonasal glands arising from seromucinous hamartoma: insight into their histogenesis. Virchows Arch 2025; 486(6): 1269-1287.
21. Skálová A, Klubíčková N, Bradová M, et al. Discovery of novel TULP4/ACTN4/EWSR1/ ACTB::MYB and ESRRG::DNM3 fusions expands molecular landscape of adenoid cystic carcinoma beyond fusions between MYB/MYBL1 and NFIB genes. Am J Surg Pathol 2024; 48(12): 1503-1511.
22. Michal M, Skálová A, Hyrcza M, et al. Nasal and sinonasal tumors formed by atypical adenomatous lesions arising in respiratory epithelial adenomatoid hamartoma/seromucinous hamartoma. Virchows Arch 2024; 485(1): 31-42.
23. Bradová M, Costes-Martineau V, Laco J, et al. Sinonasal adenosquamous carcinomas arising in seromucinous hamartoma or respiratory epithelial adenomatoid hamartoma with atypical features: report of five detailed clinicopathologic and molecular characterization of rare entity. Histopathology 2025; 86(4): 585-602.
24. Xu B, Saliba M, Ho A, et al. Head and neck acinic cell carcinoma: a new grading system proposal and diagnostic utility of NR4A3 immunohistochemistry. Am J Surg Pathol 2022; 46(7): 933–941.
25. Baněčková M, Thompson LDR, Hyrcza MD, et al. Salivary gland secretory carcinoma: clinicopathologic and genetic characteristics of 215 cases and proposal for a grading system. Am J Surg Pathol 2023; 47(6): 661-677.
26. Rooper LM, Bishop JA, Faquin WC, et al. Sinonasal tumors with neuroepithelial differentiation (olfactory carcinoma): delineation of their pathologic and clinical features with insights into their relationship to olfactory neuroblastoma and sinonasal carcinoma. Am J Surg Pathol 2022; 46(8): 1025-1035.
27. Febres-Aldana CA, Elsayad MM, Saliba M, et al. Analysis of ASCL1/NEUROD1/POU2F3/ YAP1 yields novel insights for the diagnosis of olfactory neuroblastoma and identifies sinonasal tuft cell-like carcinoma. Mod Pathol 2025; 38(3): 100674.
28. Glöss S, Jurmeister P, Thieme A, et al. IDH2 R172 mutations across poorly differentiated sinonasal tract malignancies: forty molecularly homogenous and histologically variable cases with favorable outcome. Am J Surg Pathol 2021; 45(9): 1190–1204.
29. Jurmeister P, Glöss S, Roller R et al. DNA methylation-based classification of sinonasal tumors. Nat Commun 2022; 13(1): 7148.
30. Whaley RD, Agaimy A, Bridge JA, et al. Xanthogranulomatous epithelial tumors/keratin-positive giant cell-rich tumors involving the head and neck: report of seven cases and review of the literature. Virchows Arch 2024; 485(4): 605-613.
31. Agaimy A, Antonescu CR, Bell D, et al. FGFR3::TACC3 fusions in head and neck carcinomas: a study of nine cases highlighting phenotypic heterogeneity, frequent HPV association and a morphologically distinct subset in favor of a putative entity. Virchows Arch 2025; 486(3): 499-510.
Labels
Anatomical pathology Forensic medical examiner ToxicologyArticle was published in
Czecho-Slovak Pathology
2026 Issue 2
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