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A pathologist with expertise in head and neck histopathology and cytopathology has a pivotal role in the accurate diagnosis and management of head and neck cancer. The pathologist has laboratory support for a range of specialist diagnostic and molecular tests.

Close liaison with the histopathologist is essential during the initial investigations stage for diagnosis of cancer (biopsy) and after surgery. 

Post-operative reporting of the surgically resected tumour and pathological staging of cancer provides information regarding further management and prognosis. Clear communication between the clinician and the histopathologist is essential for orientation of the specimen and to accurately assess the surgical margins for clearance of the primary tumour.   

The report will also include other important prognostic indicators such as tumour size, thickness, differentiation along with the presence or absence of lymphovascular invasion and perineural invasion. Careful examination of a well orientated neck dissection specimen gives valuable information regarding the level, number and size of lymph nodes involved by metastatic tumour. The presence of extracapsular spread in cervical lymph node metastases is often used to select patients who may benefit from adjuvant therapy.

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Poole Hospital NHS Foundation Trust, Longfleet Road, Poole, Dorset BH15 2JB. Tel: 01202 665511

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