MY 3RD JOURNEY

Surgical Pathology Case: NWS23-000732 Authorizing Provider: Tse, David G, MD Collected: 01/06/2023 08:08 AM 

Lung, left upper lobe, wedge resection:- invasive squamous cell carcinoma, keratinizing, with the following features:  - single focus, 1.7 cm maximum dimension  - moderately differentiated (grade 2)  - negative for lymphovascular invasion  - negative for visceral pleural invasion  - margins negative for invasive carcinoma    - closest margin, parenchymal, negative by 8 mm  one lymph node negative for metastatic carcinoma (0/1)   - PD-L1 positive by immunohistochemical stain  - positive for high risk HPV group by in situ hybridization  - p16 positive- additional findings:  pleural scars- see comment 

The current lung squamous cell carcinoma and the patient's previously diagnosed right tonsillar HPV-mediated squamous cell carcinoma have similar morphologic and immunohistochemical characteristics. In addition, the lung squamous cell carcinoma is positive for high risk HPV group by in situ hybridization (performed at Quest Diagnostics).  Given these results, the lung squamous cell carcinoma most likely represents a metastasis from the patient's oropharyngeal HPV-mediated squamous cell carcinoma. Dr. S. Mashru was notified of the amended results on 1/20/23.