Pathologic Features

Macroscopically, PSCCs present as papillary, friable and soft tumours, ranging in size from 2 mm to 4 cm. The main histologic feature of PSCCs is the papillary growth pattern that comprises the majority of the tumour (Fig. 1.16a). Papillae consist of a central fibrovas-cular core covered by neoplastic squamous epithelium. The covering epithelium may be composed of immature basaloid cells or may be more pleomorphic, resembling carcinoma in situ (Fig. 1.16b). It is usually non-kerati-nising or minimally keratinising.

Multiple lesions can be found, consisting either of invasive PSCCs or mucosal papillary hyperplasia. Stromal invasion is often difficult to demonstrate in biopsy specimens, and sometimes additional biopsies are needed to make the diagnosis of an invasive PSCC. A dense lym-

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