Update from the 5th Edition of the World Health Organization Classification of Head and Neck Tumors: Hypopharynx, Larynx, Trachea and Parapharyngeal Space
- PMID: 35312977
- PMCID: PMC9018940
- DOI: 10.1007/s12105-021-01405-6
Update from the 5th Edition of the World Health Organization Classification of Head and Neck Tumors: Hypopharynx, Larynx, Trachea and Parapharyngeal Space
Abstract
In this article, we review the chapter on tumors of the larynx, hypopharynx, trachea and parapharyngeal space in the new edition of the WHO book, focusing on the new developments in comparison to the previous edition. Squamous cell carcinoma (SCC) and its variants are by far the most common malignancies at these locations, with very limited new insights. The most important is the introduction of new targeted treatment-checkpoint inhibitors, with a new task for pathologists, who may help to predict the response to treatment by analyzing the expression of targeted proteins in biopsy samples. Precancerous lesions remain a controversial topic and, similarly to other organs, it is acceptable to use the terms "dysplasia" or "squamous intraepithelial lesion" (SIL), but there is a slight difference between low-grade dysplasia and low-grade SIL: in the former, mild atypia must be present, while the latter also includes hyperplastic epithelium without atypia. Two approaches have been proposed: a two-tiered system with low- and high-grade dysplasia/SIL and a three-tiered system with an additional category, carcinoma in situ. We are still searching for reliable diagnostic markers to surpass the subjectivity in biopsy diagnosis, with a few potential candidate markers on the horizon, e.g., stem cell markers. Other tumors are rare at these locations, e.g., hematolymphoid, neuroendocrine and salivary gland neoplasms, and are no longer included in Chapter 3. They must be diagnosed according to criteria described in specific chapters. The same holds true for soft tissue tumors, with the exception of cartilaginous neoplasms, which are still included in Chapter 3.
Keywords: Hypopharynx; Larynx; Precancerosis; Trachea; Tumors; WHO.
© 2022. The Author(s).
Conflict of interest statement
The authors declare that they have no conflict of interest.
Figures



Similar articles
-
Comparison of the prognoses of laryngeal preneoplastic lesions based on Ljubljana and World Health Organization classifications.Turk J Med Sci. 2023 Feb;53(1):396-404. doi: 10.55730/1300-0144.5596. Epub 2023 Feb 22. Turk J Med Sci. 2023. PMID: 36945918 Free PMC article.
-
Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: What is New in the 2017 WHO Blue Book for Tumours of the Hypopharynx, Larynx, Trachea and Parapharyngeal Space.Head Neck Pathol. 2017 Mar;11(1):23-32. doi: 10.1007/s12105-017-0788-z. Epub 2017 Feb 28. Head Neck Pathol. 2017. PMID: 28247231 Free PMC article.
-
Some Considerations on the WHO Histological Classification of Laryngeal Neoplasms.Adv Ther. 2019 Jul;36(7):1511-1517. doi: 10.1007/s12325-019-00978-7. Epub 2019 May 22. Adv Ther. 2019. PMID: 31119694 Free PMC article. Review.
-
Update from the 5th Edition of the World Health Organization Classification of Head and Neck Tumors: Soft Tissue Tumors.Head Neck Pathol. 2022 Mar;16(1):87-100. doi: 10.1007/s12105-022-01425-w. Epub 2022 Mar 21. Head Neck Pathol. 2022. PMID: 35312984 Free PMC article. Review.
-
Current views and perspectives on classification of squamous intraepithelial lesions of the head and neck.Head Neck Pathol. 2014 Mar;8(1):16-23. doi: 10.1007/s12105-014-0530-z. Epub 2014 Mar 5. Head Neck Pathol. 2014. PMID: 24595419 Free PMC article.
Cited by
-
The Follicular Dendritic Cells and HPV 18 Interrelation in Head and Neck Squamous Cell Carcinomas of the Larynx.Medicina (Kaunas). 2023 Jun 2;59(6):1072. doi: 10.3390/medicina59061072. Medicina (Kaunas). 2023. PMID: 37374276 Free PMC article.
-
Tracheal squamous cell carcinoma treated with tracheal resection and anastomosis in a dog.Can Vet J. 2025 Jun;66(6):622-627. Can Vet J. 2025. PMID: 40510272
-
Comparison of the prognoses of laryngeal preneoplastic lesions based on Ljubljana and World Health Organization classifications.Turk J Med Sci. 2023 Feb;53(1):396-404. doi: 10.55730/1300-0144.5596. Epub 2023 Feb 22. Turk J Med Sci. 2023. PMID: 36945918 Free PMC article.
-
Head and neck myofibroma: A case series of 16 cases and literature review.Med Oral Patol Oral Cir Bucal. 2024 Nov 1;29(6):e734-e741. doi: 10.4317/medoral.26673. Med Oral Patol Oral Cir Bucal. 2024. PMID: 39088720 Free PMC article. Review.
-
The sensitivity of laryngeal findings in predicting high-grade dysplasia in patients with vocal fold leukoplakia undergoing office-based biopsies: A retrospective analysis of 100 cases.Laryngoscope Investig Otolaryngol. 2024 Jan 4;9(1):e1209. doi: 10.1002/lio2.1209. eCollection 2024 Feb. Laryngoscope Investig Otolaryngol. 2024. PMID: 38362176 Free PMC article.
References
-
- Gale N, Blagus R, El-Mofty SK, Helliwell T, Prasad ML, Sandison A, et al. Evaluation of a new grading system for laryngeal squamous intraepithelial lesions—a proposed unified classification. Histopathology. 2014;65:456–64. - PubMed
-
- Wenig BM. Squamous cell carcinoma of the upper aerodigestive tract: dysplasia and select variants. Mod Pathol. 2017;30(s1):112-8. - PubMed
-
- Cho KJ, Song JS. Recent changes of classification for squamous intraepithelial lesions of the head and neck. Arch Pathol Lab Med. 2018;142:829–32. - PubMed
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
Research Materials