BACKGROUND: To predict the nodal involvement of oral squamous cell carcinoma (OSCC) many investigators have studied the histologic features of primary tumors. However, conventional histologic grading still is not sufficient to provide an objective and practical evaluation. In this study we tried to modify one standard type of histologic grading, namely, mode of invasion (MI), on the basis of the extracellular matrix (ECM) staining pattern. METHODS: One hundred seventeen initial biopsies of primary OSCC were histologically examined, and the MI was graded. The expression of a series of ECMs-laminin, type IV collagen, heparin-sulphate proteoglycan, fibronectin, tenascin, decorin, and vitronectin-was immunohistochemically examined. RESULTS: The ECM staining pattern showed a close association with the MI, and was classified into types I and II. The type I staining pattern was observed in the noninvasive cases (MI grades 1 and 2), while type II was in the highly invasive cases (MI grades 4c and 4d). Because the ECM staining pattern in the moderately invasive cases (MI grade 3) included both types I and II, these cases were subdivided and compared. As a result, the type II cases showed a significantly higher incidence of nodal involvement than did the type I cases. CONCLUSION: An examination of a series of the ECMs, in addition to the conventional histologic examination, is thus considered to provide more objective and practical data to evaluate the invasive and metastatic potential of OSCC.

Carcinoma, Squamous Cell↗

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Testicular epidermoid cysts: sonographic features with histopathologic correlation.

Testicular epidermoid cysts are rare, accounting for 1% of all testicular tumors. We present the sonographic appearances of epidermoid cysts in 3 cases, together with the histopathologic correlation. In case 1, sonography showed an intratesticular hypoechoic mass with a well-defined echogenic rim; the mass measured 1.8 x 1.5 x 1.5 cm, and there was no evidence of calcification. In case 2, sonography showed a well-circumscribed mass measuring 1.3 x 1.3 x 1.0 cm, with alternating hypoechoic and hyperechoic rings (onion-ring appearance) and no calcifications. In case 3, sonography showed a 2.4- x 2.3- x 2.3-cm, well-circumscribed, oval mass with a heterogeneous echotexture and an outer hypoechoic halo. The mass contained plaque-like regions of increased echogenicity, with peripheral acoustic shadowing from refraction artifact. Hypoechoic clefts were visualized posterior to the plaque-like areas. The triad of findings-sonographic appearance of an onion ring, avascularity on Doppler sonography, and negative results of tumor marker studies-is highly suggestive of an epidermoid cyst.

Adult↗