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A polypoid mucosal lesion in the oral cavity generally signifies a soft tissue pathology that is benign. The aetiology can vary from inflammatory conditions to fibrous tumours. Occasionally a malignant lesion can manifest as a polypoid oral mucosal lesion [1]. We would like to describe a case of a rare variant of squamous cell carcinoma, a spindle cell squamous cell carcinoma (SpSCC), presenting as a polypoid mucosal lesion. It is important to ascertain a diagnosis based on history and clinical examination, so that vital findings are not missed and speedy treatment can be instituted.

In the past there has been considerable variation in the way thyroid cytology was reported by pathologists As the need for improving patient care increased to include more conservative surgical procedures for the management of thyroid lesions there was a need for a standardized reporting format This had to be reproducible and universal so that the implications of the reporting categories were clear to all pathologists surgeons or clinicians In The Royal College of Pathologists RCPath published lsquo Guidance on Reporting of Thyroid Cytology Specimens rsquo and this guidance has been revised in This document details the standardized format for reporting Thyroid FNAC used in the UK today The classification of thyroid cytology into lsquo Thy categories rsquo is similar to the Bethesda system used in the USA in that it stratifies thyroid FNA rsquo s into various disease categories The UK system uses five main categories ranging from Thy Thy and certain categories are further subdivided into a or b to give additional diagnostic information The Bethesda system uses six categories each with a percentage risk of malignancy Currently there is little national data available on the percentage of cases that fall into each Thy category Hence the positive predictive value PPV for each Thy category suggested in the RCPath guidance although rudimentary is present target nbsp This audit was conducted at Wycombe Hospital Cellular pathology department to assess the adherence to RCPath lsquo Guidance on reporting of Thyroid Cytology Specimens rsquo In addition to the aspects of the audit outlined in the guidance we have also gathered information on the accuracy of local diagnostic opinions compared to those of specialists at the regional MDT to determine if there are large discrepancies between local and specialist practice nbsp