{"id":"https://openalex.org/W7225413465","doi":"https://doi.org/10.5281/zenodo.24013439","title":"HPV-Associated Metastatic Squamous Cell Carcinoma of Cervical Lymph Node Mimicking Nasopharyngeal Carcinoma: Diagnostic Utility of p16 and EBER In Situ Hybridization.","display_name":"HPV-Associated Metastatic Squamous Cell Carcinoma of Cervical Lymph Node Mimicking Nasopharyngeal Carcinoma: Diagnostic Utility of p16 and EBER In Situ Hybridization.","publication_year":2026,"publication_date":"2026-11-06","ids":{"openalex":"https://openalex.org/W7225413465","doi":"https://doi.org/10.5281/zenodo.24013439"},"language":"en","primary_location":{"id":"doi:10.5281/zenodo.24013439","doi":"https://doi.org/10.5281/zenodo.24013439","is_oa":true,"landing_page_url":"https://doi.org/10.5281/zenodo.24013439","pdf_url":null,"source":{"id":"https://openalex.org/S4306400562","display_name":"Zenodo (CERN European Organization for Nuclear Research)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I67311998","host_organization_name":"European Organization for Nuclear Research","host_organization_lineage":["https://openalex.org/I67311998"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"article-journal"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["datacite"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.5281/zenodo.24013439","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5146010992","display_name":"Jos\u00e9 Luis Milan\u00e9s S\u00e1nchez","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Milan\u00e9s S\u00e1nchez, Jos\u00e9 Luis","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":["https://openalex.org/A5146010992"],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10307","display_name":"Head and Neck Cancer Studies","score":0.7827000021934509,"subfield":{"id":"https://openalex.org/subfields/2733","display_name":"Otorhinolaryngology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10307","display_name":"Head and Neck Cancer Studies","score":0.7827000021934509,"subfield":{"id":"https://openalex.org/subfields/2733","display_name":"Otorhinolaryngology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12379","display_name":"Cancer Diagnosis and Treatment","score":0.08780000358819962,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12992","display_name":"Metastasis and carcinoma case studies","score":0.04230000078678131,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/cervical-lymph-node-metastasis","display_name":"cervical lymph node metastasis","score":0.9850000143051147},{"id":"https://openalex.org/keywords/p16-immunohistochemistry","display_name":"p16 immunohistochemistry","score":0.7910000085830688},{"id":"https://openalex.org/keywords/eber-in-situ-hybridization","display_name":"EBER in situ hybridization","score":0.996999979019165},{"id":"https://openalex.org/keywords/epstein-barr-virus","display_name":"Epstein-Barr virus","score":0.7179999947547913},{"id":"https://openalex.org/keywords/non-keratinizing-squamous-cell-carcinoma","display_name":"non-keratinizing squamous cell carcinoma","score":0.8489999771118164},{"id":"https://openalex.org/keywords/occult-primary-tumor","display_name":"occult primary tumor","score":0.6119999885559082},{"id":"https://openalex.org/keywords/differential-diagnosis","display_name":"differential diagnosis","score":0.5690000057220459},{"id":"https://openalex.org/keywords/head-and-neck-squamous-cell-carcinoma","display_name":"head and neck squamous cell carcinoma","score":0.7829999923706055},{"id":"https://openalex.org/keywords/oropharyngeal-cancer","display_name":"oropharyngeal cancer","score":0.6159999966621399}],"concepts":[{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.7276999950408936},{"id":"https://openalex.org/C2778997737","wikidata":"https://www.wikidata.org/wiki/Q1693598","display_name":"Nasopharyngeal carcinoma","level":3,"score":0.6897000074386597},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6815000176429749},{"id":"https://openalex.org/C2780849966","wikidata":"https://www.wikidata.org/wiki/Q170758","display_name":"Lymph node","level":2,"score":0.5738999843597412},{"id":"https://openalex.org/C2778549279","wikidata":"https://www.wikidata.org/wiki/Q962200","display_name":"Cervical lymph nodes","level":4,"score":0.5410000085830688},{"id":"https://openalex.org/C2779768787","wikidata":"https://www.wikidata.org/wiki/Q6985524","display_name":"Neck mass","level":2,"score":0.5230000019073486},{"id":"https://openalex.org/C204232928","wikidata":"https://www.wikidata.org/wiki/Q899285","display_name":"Immunohistochemistry","level":2,"score":0.5090000033378601},{"id":"https://openalex.org/C2776833033","wikidata":"https://www.wikidata.org/wiki/Q1783924","display_name":"Head and neck squamous-cell carcinoma","level":4,"score":0.503600001335144},{"id":"https://openalex.org/C2779655305","wikidata":"https://www.wikidata.org/wiki/Q5065339","display_name":"Cervical lymphadenopathy","level":3,"score":0.45969998836517334},{"id":"https://openalex.org/C2779975986","wikidata":"https://www.wikidata.org/wiki/Q6823250","display_name":"Metastatic carcinoma","level":3,"score":0.4519999921321869},{"id":"https://openalex.org/C81439078","wikidata":"https://www.wikidata.org/wiki/Q2304142","display_name":"In situ hybridization","level":4,"score":0.45080000162124634},{"id":"https://openalex.org/C181152851","wikidata":"https://www.wikidata.org/wiki/Q712604","display_name":"Lymphatic system","level":2,"score":0.43560001254081726},{"id":"https://openalex.org/C2775934546","wikidata":"https://www.wikidata.org/wiki/Q179991","display_name":"Biopsy","level":2,"score":0.42590001225471497},{"id":"https://openalex.org/C2780801072","wikidata":"https://www.wikidata.org/wiki/Q837512","display_name":"Differential diagnosis","level":2,"score":0.38179999589920044},{"id":"https://openalex.org/C2777546739","wikidata":"https://www.wikidata.org/wiki/Q33525","display_name":"Carcinoma","level":2,"score":0.37220001220703125},{"id":"https://openalex.org/C2777048871","wikidata":"https://www.wikidata.org/wiki/Q17125282","display_name":"Lymphoepithelioma","level":4,"score":0.3666999936103821},{"id":"https://openalex.org/C2780283643","wikidata":"https://www.wikidata.org/wiki/Q2110267","display_name":"Primary tumor","level":4,"score":0.3328999876976013},{"id":"https://openalex.org/C2778474501","wikidata":"https://www.wikidata.org/wiki/Q355817","display_name":"Neck dissection","level":3,"score":0.325300008058548},{"id":"https://openalex.org/C2994460389","wikidata":"https://www.wikidata.org/wiki/Q681817","display_name":"Epidermoid carcinoma","level":3,"score":0.29600000381469727},{"id":"https://openalex.org/C2779338263","wikidata":"https://www.wikidata.org/wiki/Q208414","display_name":"Lymphoma","level":2,"score":0.2953999936580658},{"id":"https://openalex.org/C2779720271","wikidata":"https://www.wikidata.org/wiki/Q179422","display_name":"Lymph","level":2,"score":0.295199990272522},{"id":"https://openalex.org/C2778818763","wikidata":"https://www.wikidata.org/wiki/Q6708226","display_name":"Lymph node biopsy","level":3,"score":0.2865999937057495},{"id":"https://openalex.org/C138055712","wikidata":"https://www.wikidata.org/wiki/Q924466","display_name":"Koilocyte","level":5,"score":0.2849999964237213},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.27810001373291016},{"id":"https://openalex.org/C2781375147","wikidata":"https://www.wikidata.org/wiki/Q6900","display_name":"Epstein\u2013Barr virus","level":3,"score":0.26899999380111694},{"id":"https://openalex.org/C2777661416","wikidata":"https://www.wikidata.org/wiki/Q1035645","display_name":"Carcinoma in situ","level":3,"score":0.26249998807907104},{"id":"https://openalex.org/C2994491419","wikidata":"https://www.wikidata.org/wiki/Q681817","display_name":"Squamous carcinoma","level":3,"score":0.2596000134944916}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.5281/zenodo.24013439","doi":"https://doi.org/10.5281/zenodo.24013439","is_oa":true,"landing_page_url":"https://doi.org/10.5281/zenodo.24013439","pdf_url":null,"source":{"id":"https://openalex.org/S4306400562","display_name":"Zenodo (CERN European Organization for Nuclear Research)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I67311998","host_organization_name":"European Organization for Nuclear Research","host_organization_lineage":["https://openalex.org/I67311998"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"article-journal"},{"id":"doi:10.5281/zenodo.24013440","doi":"https://doi.org/10.5281/zenodo.24013440","is_oa":true,"landing_page_url":"https://doi.org/10.5281/zenodo.24013440","pdf_url":null,"source":{"id":"https://openalex.org/S4306400562","display_name":"Zenodo (CERN European Organization for Nuclear Research)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I67311998","host_organization_name":"European Organization for Nuclear Research","host_organization_lineage":["https://openalex.org/I67311998"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"article-journal"}],"best_oa_location":{"id":"doi:10.5281/zenodo.24013439","doi":"https://doi.org/10.5281/zenodo.24013439","is_oa":true,"landing_page_url":"https://doi.org/10.5281/zenodo.24013439","pdf_url":null,"source":{"id":"https://openalex.org/S4306400562","display_name":"Zenodo (CERN European Organization for Nuclear Research)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I67311998","host_organization_name":"European Organization for Nuclear Research","host_organization_lineage":["https://openalex.org/I67311998"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"article-journal"},"sustainable_development_goals":[{"score":0.979200005531311,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Case Report","id":"https://openalex.org/study-designs/case-report"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7135219614","https://openalex.org/W2056123952","https://openalex.org/W2296956079","https://openalex.org/W2038104848","https://openalex.org/W2089074400","https://openalex.org/W3031836417","https://openalex.org/W2756428971","https://openalex.org/W2017877560","https://openalex.org/W3118767784","https://openalex.org/W7147208866"],"abstract_inverted_index":{"Abstract":[0],"Background:":[1],"Metastatic":[2,566,743],"squamous":[3,104,154,160,231,273,304,436,474,644,745,776,834,903,945],"cell":[4,105,155,161,232,274,305,475,645,746,777,904,946],"carcinoma":[5,106,162,168,233,580,646,747,778],"presenting":[6,632,799],"as":[7,323,586,650,671,696],"an":[8,58,720],"upper":[9,601],"cervical":[10,60,73,201,371,602,655,753,801,820],"neck":[11,61,243,358,724,880,902,925],"mass":[12,62],"(Level":[13],"II)":[14],"frequently":[15],"poses":[16],"a":[17,70,96,149,236,286,324,355,363,368,478,651,672,837,927],"diagnostic":[18,109,318,906],"challenge":[19],"regarding":[20],"the":[21,24,246,263,342,388,460,467,496,561,638,688,700,703,714,717,733,819,883,886],"identification":[22],"of":[23,69,86,111,151,280,367,380,394,409,428,482,564,582,641,668,705,804,818,832,855,877,888,920],"primary":[25,192,200,247,635,652,725],"tumor":[26,120,497],"site.":[27],"Non-keratinizing":[28,272],"morphologies":[29],"with":[30,57,90,107,354,531,611,633,748,800,859],"prominent":[31,97,175,445,749,838,863],"lymphoid":[32,77,98,176,288,448,750,839],"stroma":[33,751],"strongly":[34,124,290],"suggest":[35],"Epstein-Barr":[36,293],"virus":[37,294],"(EBV)-associated":[38],"nasopharyngeal":[39,112,167,296,486,542,579,627,697,759,781],"carcinoma,":[40,476],"though":[41],"they":[42],"can":[43,163,307,756],"occasionally":[44],"mask":[45],"Human":[46,300],"Papillomavirus":[47,301],"(HPV)-related":[48],"oropharyngeal":[49,270,303,575,643,944],"primaries.":[50,271],"Case":[51,346],"Presentation:":[52],"A":[53,178,350,444],"53-year-old":[54,351],"male":[55,352],"presented":[56,353],"enlarging":[59,357],"for":[63,126,190,327,662,676,691,940],"investigation.":[64],"Initial":[65],"core":[66,364,389],"needle":[67,365],"biopsy":[68,366,390],"Level":[71,369,461],"II":[72,370,462,606],"lymph":[74,372,395,603,754,821],"node":[75,396,822],"revealed":[76],"tissue":[78],"extensively":[79,398],"infiltrated":[80,399],"by":[81,277,403,827],"nests":[82,829],"and":[83,95,116,130,139,141,174,183,195,222,242,258,269,382,400,406,425,438,456,464,499,505,526,577,592,607,616,709,723,738,763,785,794,830,865,879,901,907,924],"syncytial":[84,172,278,407,465,614],"sheets":[85,831,854],"atypical":[87,281,410,833],"epithelial":[88,282,411,516,857],"cells":[89,121,283,415,835,858],"vesicular":[91,418,861],"nuclei,":[92,419,862],"conspicuous":[93,423],"nucleoli,":[94,424,864],"background,":[99],"initially":[100],"favoring":[101],"metastatic":[102,153,159,230,472],"non-keratinizing":[103,311,473,598,744],"differential":[108,264,480,665],"consideration":[110,653],"carcinoma.":[113,156,297,487,698,760,782,947],"Subsequent":[114],"immunohistochemical":[115,259],"molecular":[117],"characterization":[118,787],"demonstrated":[119],"that":[122,313],"were":[123,442,509],"positive":[125,513,524],"CK":[127,556],"AE1/AE3,":[128],"p40,":[129],"p16,":[131,213],"while":[132],"EBER":[133,184,214,331,534,683,711,764],"in":[134,185,198,215,240,335,506,514,600,630,654,684,752,765,797,882,922,943],"situ":[135,186,216,336,507,685,766],"hybridization":[136,187,337,508,686,767],"was":[137,450],"negative,":[138],"CD3":[140,544],"CD20":[142],"highlighted":[143],"background":[144,289,447,549,840],"lymphocytes.":[145,551,619],"These":[146,620],"findings":[147],"confirmed":[148,560],"diagnosis":[150,265,481,563],"HPV-associated":[152,205,642,775,899],"Conclusion:":[157],"HPV-related":[158,721],"closely":[164],"mimic":[165,758],"EBV-associated":[166,780],"morphologically":[169,757],"due":[170],"to":[171,229,261,340,590,625,719,773],"growth":[173],"stroma.":[177],"panel":[179],"including":[180],"p16":[181,321,669,707,761,941],"immunohistochemistry":[182,322,504,762],"is":[188,235,249,338,581],"essential":[189],"accurate":[191],"site":[193,248,726],"attribution":[194],"prognostic":[196,795],"stratification":[197],"unknown":[199,805],"nodal":[202,656,802],"metastases.":[203,657],"Keywords":[204],"Squamous":[206,567],"Cell":[207,568],"Carcinoma,":[208],"Cervical":[209,226],"Lymph":[210],"Node":[211],"Metastasis,":[212],"hybridization,":[217],"Nasopharyngeal":[218],"Carcinoma":[219],"mimic,":[220],"Head":[221,891,910,948],"Neck":[223,892,911,949],"Pathology.":[224],"Introduction":[225],"lymphadenopathy":[227],"secondary":[228],"(SCC)":[234],"frequent":[237],"clinical":[238,584,790],"presentation":[239],"head":[241,722,878,900,923],"oncology.":[244],"When":[245],"occult,":[250],"pathologists":[251,624],"must":[252],"rely":[253],"heavily":[254],"on":[255],"morphologic":[256],"clues":[257],"panels":[260],"narrow":[262],"between":[266,573],"nasopharyngeal,":[267],"sinonasal,":[268],"carcinomas":[275,306],"characterized":[276],"aggregates":[279,408],"embedded":[284],"within":[285,836],"brisk":[287,453,866],"point":[291],"toward":[292],"(EBV)-driven":[295],"However,":[298,637],"high-risk":[299,328,679],"(HPV)-associated":[302],"exhibit":[308],"basaloid":[309,612],"or":[310,484,729],"features":[312,621],"overlap":[314],"morphologically,":[315],"creating":[316],"potential":[317],"pitfalls.":[319],"Utilizing":[320],"surrogate":[325,674],"marker":[326,675],"HPV":[329,532,680,921],"alongside":[330,452],"(Epstein-Barr":[332],"virus-encoded":[333],"RNA)":[334],"critical":[339],"establishing":[341],"correct":[343],"biological":[344],"etiology.":[345],"Presentation":[347,349],"Clinical":[348],"persistent,":[356],"mass.":[359],"Diagnostic":[360],"workup":[361],"included":[362],"node.":[373],"Histopathology":[374],"(Initial":[375],"Core":[376],"Biopsy)":[377],"Microscopic":[378],"examination":[379],"Hematoxylin":[381],"Eosin":[383],"(H&E)":[384],"stained":[385],"sections":[386],"from":[387,716,779],"showed":[391],"multiple":[392],"fragments":[393],"parenchyma":[397],"partially":[401],"replaced":[402],"nests,":[404],"sheets,":[405],"cells.":[412,517],"The":[413,552,571,874,918],"neoplastic":[414,515],"displayed":[416],"enlarged":[417,860],"irregular":[420],"nuclear":[421],"contours,":[422],"moderate":[426],"amounts":[427],"eosinophilic":[429],"cytoplasm":[430],"(Figure":[431],"1,":[432],"Figure":[433,807,809,843],"2).":[434],"Overt":[435],"maturation":[437],"keratin":[439],"pearl":[440],"formation":[441],"absent.":[443],"reactive":[446,550],"population":[449],"present":[451,610,701],"mitotic":[454],"activity":[455,868],"apoptotic":[457,867],"bodies.":[458],"Given":[459],"location":[463],"architecture,":[466],"initial":[468],"morphological":[469],"impression":[470],"favored":[471],"raising":[477],"strong":[479,706],"differentiated":[483],"undifferentiated":[485],"Advanced":[488],"Immunohistochemical":[489],"&":[490,545],"Molecular":[491],"Findings":[492],"To":[493],"definitively":[494,712],"characterize":[495],"lineage":[498,786],"investigate":[500],"viral":[501,784],"association,":[502],"specialized":[503],"performed:":[510],"p40:":[511],"Strongly":[512],"Cytokeratin":[518],"AE1/AE3:":[519],"Diffusely":[520,523],"positive.":[521],"p16:":[522],"(nuclear":[525],"cytoplasmic":[527],"staining":[528],"pattern":[529],"consistent":[530],"association).":[533],"(In":[535],"Situ":[536],"Hybridization):":[537],"Negative":[538],"(ruling":[539],"out":[540],"EBV-driven":[541,578,693],"carcinoma).":[543],"CD20:":[546],"Highlighted":[547],"normal":[548],"combined":[553],"immunophenotype":[554],"(p40+,":[555],"AE1/AE3+,":[557],"p16+,":[558],"EBER-)":[559],"definitive":[562],"HPV-Associated":[565],"Carcinoma.":[569],"Discussion":[570],"distinction":[572],"HPV-mediated":[574],"SCC":[576],"paramount":[583],"importance,":[585],"treatment":[587],"paradigms,":[588],"response":[589],"therapy,":[591],"overall":[593],"prognosis":[594],"differ":[595],"significantly.":[596],"Morphologically,":[597],"SCCs":[599],"nodes":[604,755],"(Levels":[605],"III)":[608],"often":[609],"features,":[613],"growth,":[615],"extensive":[617,824],"tumor-infiltrating":[618],"historically":[622],"led":[623],"suspect":[626],"primaries,":[628],"particularly":[629],"patients":[631,798],"occult":[634],"lesions.":[636],"global":[639],"rise":[640],"has":[647],"established":[648],"it":[649],"Immunohistochemistry":[658],"provides":[659],"reliable":[660],"tools":[661],"resolving":[663],"this":[664],"diagnosis.":[666],"Overexpression":[667],"serves":[670],"robust":[673],"transcriptionally":[677],"active":[678],"infection.":[681],"Conversely,":[682],"remains":[687],"gold":[689],"standard":[690],"confirming":[692],"malignancies":[694],"such":[695],"In":[699],"case,":[702],"combination":[704],"positivity":[708],"negative":[710],"redirected":[713],"origin":[715],"nasopharynx":[718],"(frequently":[727],"palatine":[728],"lingual":[730],"tonsils),":[731],"sparing":[732],"patient":[734],"inappropriate":[735],"nasopharyngeal-directed":[736],"evaluations":[737],"optimizing":[739],"oncological":[740],"management.":[741],"Conclusions":[742],"are":[768],"indispensable":[769],"ancillary":[770],"tests":[771],"required":[772],"differentiate":[774],"Accurate":[783],"directly":[788],"impacts":[789],"staging,":[791],"therapeutic":[792,908],"targeting,":[793],"counseling":[796],"metastases":[803],"primary.":[806],"Captions":[808],"1":[810],"(Microfotograf\u00eda":[811,845],"-":[812,846],"H&E,":[813,847],"Low":[814],"Power):":[815,849],"Histologic":[816],"section":[817],"showing":[823],"architectural":[825],"replacement":[826],"confluent":[828],"(H&E,":[841,869],"10x).":[842],"2":[844],"High":[848],"High-power":[850],"view":[851],"demonstrating":[852],"cohesive":[853],"malignant":[856],"40x).":[870],"References":[871],"Westra":[872],"WH.":[873],"changing":[875],"face":[876],"cancer":[881],"21st":[884],"century:":[885],"impact":[887],"HPV.":[889],"Otolaryngol":[890],"Surg.":[893],"2010;142(5):7-13.":[894],"Shanbaug":[895],"S,":[896],"et":[897,916,936],"al.":[898,917,937],"carcinoma:":[905],"updates.":[909],"Pathol.":[912,950],"2019;13(1):31-42.":[913],"StGuily":[914],"JL,":[915],"role":[919],"cancer:":[926],"review.":[928],"Eur":[929],"Arch":[930],"Otorhinolaryngol.":[931],"2020;277(8):2161-2170.":[932],"Lewis":[933],"JS":[934],"Jr,":[935],"Provisional":[938],"guidelines":[939],"testing":[942],"2018;12(2):147-152.":[951]},"counts_by_year":[],"updated_date":"2026-11-08T12:12:28.789561","created_date":"2026-11-07T00:00:00"}
