Head and neck Cytopathology: Options for high-risk HPV testing in head and neck FNA specimens, a concise review

High-risk human papillomavirus (HR-HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) is a unique form of head and neck cancer with distinct biology and better prognosis than conventional SCC. Many patients with HR-HPV positive OPSCC initially present with metastases to lateral neck lymph nodes in levels II or III. Fine-needle aspiration (FNA) is routinely used to establish a diagnosis and evaluate HPV status at these sites. However, there is no consensus regarding the best testing methods for establishing HPV status in cytology specimens. The most common methods include p16 immunohistochemistry, HR-HPV in situ hybridization and molecular tests. This review summarizes the advantages and limitation of each method.