T2 carcinoma of the tongue: the histopathologist's perspective

The histological characteristics and extent of tumour spread at the primary site and in the neck are described in a series of 50 patients with a T2 sq uamous cell carcinoma of the oral tongue. The likely site of origin was lat eral tongue in 29 cases and ventral tongue in 21 cases. Simultaneous tumour s were evident in four resections and multifocal dysplasia in a further 13, Lymph node metastasis was diagnosed histologically in 27 cases, including one case with bilateral metastases, Comparison of the groups, with and with out metastasis, showed significant differences in tumour thickness, tumour diameter, multifactorial histological malignancy grade, vessel invasion and nerve invasion. The number of positive lymph nodes per patient ranged from 1 to 16 (mean 3), and 17 dissections showed spread beyond the nodal capsul e, Postoperative follow-up ranged from 1 to 6 years and, at the time of ana lysis, 18 patients had died of or with disease. Loco-regional failure was r elated to 'high-risk' features at the primary site and extracapsular spread in the neck.