Histopathology

Histologically, the tumour usually grows beneath an intact stratified squamous epithelium. It usually exhibits pushing borders and comprises fascicles, whorls, nodules, storiform arrays or diffuse sheets of spindly to ovoid tumour cells sprinkled with small lymphocytes. The tumour cells usually show ill-defined cell borders, distinct nucleoli, and sometimes nuclear pseudoinclusions. There is a tendency for some nuclei to be haphazardly clustered, and scattered multincleated tumour cells are common. While nuclear pleomorphism is usually mild, some cases can show significant nuclear atyp-ia and pleomorphism. The cytoplasm is eosinophilic, and often exhibits a fibrillary quality as a result of the presence of inter-digitating cell processes. Very rarely, the tumour cells have distinct cell borders, and are polygonal or oval in shape. The mitotic count ranges from low to high, and some cases can show coagulative necrosis. Occasional cases may show irregular interspersed cystic spaces. Besides being intermingled among the tumour cells, the lymphocytes can show cuffing around the blood vessels. The diagnosis has to be confirmed by demonstration of FDC markers (e.g. CD21, CD23 and CD35), although the staining can be patchy. Typically a mesh-

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