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Biomedical subjects

E L Barnes

Publications and source records attributed to E L Barnes.

43 records · Page 3Linked to original sources

Base of tongue salivary gland tumors.

Salivary tumors of the base of the tongue are encountered infrequently. A retrospective review of medical records from 1955 to 1985 was undertaken to determine the incidence of occurrence and to assess the outcome of the therapy provided. One hundred seventy-eight minor salivary gland tumors of the oral cavity and oropharynx were identified, of which 22 (13%) were located in the tongue base. All were malignant. The most common histologic type was mucoepidermoid carcinoma (10 patients), followed by adenocarcinoma (6 patients), and adenoid cystic carcinoma (6 patients). Thirteen patients were available for a mean follow-up of 5 years. Treatment was most often a combination of wide resection combined with postoperative radiation therapy. Ten patients (77%) are alive, one with persistent disease 8 years after diagnosis. Three patients died within 2 years of diagnosis, one with intercurrent disease. Improved control of disease in this series, when compared to previously reported series, is attributed to adequate surgical therapy and adjuvant radiotherapy. The deaths in our series occurred in patients who were unable to proceed with the recommended therapy. These unusual lesions require aggressive multimodality treatment for improved survival.

Adenocarcinoma↗

Cytokeratin immunophenotyping of an unusual cervical vertebral chordoma with extensive chondroid foci and perilaryngeal recurrence: a case report with review of the literature.

Chordomas are midline, slowly growing, and locally destructive tumors derived from vestigial remnants of the notochord. We present an unusual case of a cervical vertebral chordoma with extensive chondroid change that aggressively recurred in the anterior larynx and surrounding neck structures, and subsequently in the mediastinum, resulting in the death of the patient. Recent literature has investigated and debated the significance of chondroid elements in chordomas as a differential diagnostic and a prognostic indicator. In particular, the use of immunohistochemical stains for cytokeratin and mesenchymal markers in these areas as a means of distinguishing true from pseudocartilage has received much attention. In this study, we used a spectrum of cytokeratin subtypes (CK 7, 20, 5/6, AE1/3) to further characterize these chondroid areas, and observed that they were positive for the majority of the cytokeratin subtypes, suggesting pseudo, rather than true, cartilaginous change. Clinicopathologic features of this lesion and the recent literature are reviewed.

Aged↗

Laryngeal amyloidosis: clinicopathologic study of seven cases.

The larynx is usually involved with amyloid as an isolated phenomenon and infrequently in generalized amyloidosis. This study includes six females and one male with an average age of 54 years who complained chiefly of prolonged hoarseness. At direct laryngoscopy, the amyloid usually presented as firm, nonulcerated yellow, red, or white lesions most often involving the ventricle, true and false cords. Surgical biopsy and/or excision was the only form of treatment. One patient experienced recurrence of her amyloid seven years after her first operation while another patient developed extralaryngeal amyloid. Amyloid is deposited extracellularly as amorphous eosinophilic material in vascular walls and basement membranes of minor salivary glands, as random tissue masses, or as "rings" in adipose tissue. Under the electron microscope, all types of amyloid have the same basic structure. However, chemical analysis has revealed three different classes of amyloid: amyloid of immunoglobulin origin, amyloid of unknown origin, and apudamyloid. Evidence suggests an immunoglobulin origin of at least some cases of amyloid localized to the larynx. It is theorized that the secretions of a monoclonal plasmacytic infiltrate of the larynx are metabolized into immunoglobulin light chain fragments by adjacent histiocytes and deposited extracellularly as amyloid.

Adult↗

Adult onset laryngeal papillomatosis.

The charts of 22 patients with an onset of laryngeal papillomatosis after age 18 were reviewed retrospectively. The typical patient had hoarseness. Airway obstruction did not occur in this series. One half of the patients had one recurrence or less of their papilloma. The remainder of the patients encountered multiple recurrences. The histologic criteria of mitosis and dysplasia reflected recent past activity and correlated poorly with subsequent clinical behavior. Malignancy did not occur in the larynx of any of these adult onset laryngeal papilloma patients followed from 1 to 20 years.

Adult↗

Histopathology of tissue samples removed using the microdebrider technique: implications for endoscopic sinus surgery.

Microdebriders are being used with increasing frequency in endoscopic sinus surgery to provide precise removal of soft tissue and bone with simultaneous suction and irrigation. To date, no one has analyzed whether histopathology of tissue processed through a microdebrider is maintained. Fifteen tissue samples (squamous cell cancer, esthesioneuroblastoma, lymphoma, sarcoma, inverted papilloma, benign thyroid, and nasal mucosa) were processed though a microdebrider in various modes and speeds. Pathology slides were developed, coded, and presented as unknowns to the pathologist for diagnosis. Specimens taken from routine biopsy techniques were then compared to those passed through the microdebrider. The study found no significant loss of morphologic features in the tissue passed through the microdebrider. The microdebrider may be used for both routine and oncologic procedures without altering the histopathology necessary for diagnosis.

Biopsy↗

Collagen accumulation by dermal fibroblast cultures of patients with linear localized scleroderma.

Two patients with linear localized scleroderma are reported. Punch biopsies from involved and contralateral site-matched uninvolved dermis of each patient were explained for the purpose of studying connective tissue accumulation in fibroblast monolayer culture. Monolayer cultures from involved tissue accumulated more collagen and glycosaminoglycan than cultures from uninvolved tissue for both patients. Augmented accumulation of collagen persisted for at least 11 subpassages. Involved monolayers acquired a strikingly different macroscopic appearance in confluent cultures.

Adolescent↗