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Pathology · single question

Where is HPV (Human Papillomavirus) most likely to become malignant in the oropharynx?

  1. Buccal mucosa
  2. Tongue (lateral border)
  3. Floor of the mouth
  4. Tonsils
Show answer and explanation

Correct answer: D. Tonsils

  • A. INCORRECT — Buccal mucosa carcinoma is more commonly associated with tobacco, betel nut use, or mechanical trauma rather than HPV.
  • B. INCORRECT — The lateral tongue is a common site for non-HPV oral squamous cell carcinoma (related to tobacco/alcohol), not the primary site for HPV-driven malignancy.
  • C. INCORRECT — Floor of the mouth is a high-risk site for squamous cell carcinoma, but HPV-associated SCC predominantly affects the oropharynx, not the floor of mouth.
  • D. CORRECT — The TONSILS (and the base of tongue) are the primary sites of HPV-related oropharyngeal squamous cell carcinoma. HPV-16 has particular tropism for the tonsillar crypt epithelium. HPV-positive oropharyngeal SCC arises predominantly from tonsillar tissue.

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