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At least 217 records · Page 12Linked to original sources

Adenoid basal carcinomas of the cervix: a unique morphological evolution with cell cycle correlates.

Adenoid basal carcinoma (ABC) is a rare cervical carcinoma of postmenopausal women composed of small basal-type (basaloid) cells with focal endocervical ("adenoid") differentiation. ABCs are associated with high-grade squamous intraepithelial lesions (HSIL) and contain integrated human papillomavirus type 16 DNA. However, ABCs have a favorable prognosis and do not metastasize. Five (5) ABCs were analyzed histologically for a marker distinguishing basal/ squamous from columnar (adenoid) differentiation (p63) and cell cycle activity (Ki-67), and compared with 20 cervical (CC) carcinomas. In contrast to other CCs, ABCs contained 4 distinct components, including (1) a classic HSIL; (2) a limited invasive component with squamoid maturation, often with a discrete layer of peripheral basal cells; (3) outgrowth of small basal cells from either HSIL or squamoid areas; (4) focal endocervical (adenoid) differentiation. ABCs showed distinct differences in cell cycle activity relative to CCs. Ki-67 positivity was high in associated HSILs but remained high and concentrated in the suprabasal cells of the invasive squamoid component of ABC. Moreover, proliferative index was variable to sharply reduced in areas of basaloid and adenoid differentiation, in contrast to conventional CCs. ABC is a unique neoplasm, not only by its transition through multiple phenotypes during invasion, but also by a proliferative index that is high in more mature neoplastic cells during the infiltrative process and reduced with progressive basal differentiation. The precise mechanism underlying this unique process of tumor evolution is unclear. However, the postmenopausal status of these patients suggests that host factors related to aging may influence tumor evolution and morphology after HPV 16 infection.

Basal Cell Carcinoma↗

Adenoid squamous cell carcinoma of the skin overlying the right breast. An autopsy case clinically manifested with rapid growth and widely spreading metastases.

An autopsy case of a 62-year-old woman with a poorly differentiated, aggressive form of adenoid squamous cell carcinoma arising in the skin overlying the right breast was studied. The tumor, 9 X 8 cm in diameter, had rapidly enlarged since one year before admission from a verrucous lesion of 20 years duration. The histologic features of the tumor showed a well-differentiated squamous cell carcinoma mainly in the superficial areas, which transformed into, with a zone of transition in between, an alveolar or adenoid structure in the deep invading portion. The adenoid tumor cells exhibited an undifferentiated appearance with prominent nucleoli and frequent mitotic figures. These cells partly showed dyskeratotic or acantholytic features. Mucin was negative. The patient died at 8 months after the operation. Autopsy revealed widely spreading metastases in which an adenoid structure was outstanding. These unusual pathological features and an aggressive behavior of this tumor, which were hitherto rarely described for adenoid squamous cell carcinoma, seemed to be a poorly differentiated variant of the tumor. This malignant transformation might be derived from loss of cohesion of the pre-existing usual well-differentiated squamous cell carcinoma in the basal and parabasal layers, inparting marked invasiveness of these cells into the supporting connective tissue.

Aged↗

Adenoid glioblastoma arising in a patient with neurofibromatosis type-1.

An unusual case of glioblastoma with adenoid structures arising in a 30-year-old Japanese woman with neurofibromatosis type-1 (NF1) is reported. The patient was admitted to University of Miyazaki Hospital, complaining of headache, nausea and vomiting. From the neuroradiological findings the patient was diagnosed as having glioblastoma, and the tumor was surgically resected. Histologically, the tumor consisted mainly of dark basophilic cells showing prominent tubular or glandular structures surrounded by large eosinophilic cells, in addition to the typical glioblastoma features in the periphery of the tumor. Both cells showed strong stainability with glial fibrillary acidic protein (GFAP) and S-100 protein immunohistochemically, so that the tumor was classified as adenoid glioblastoma. Several cases of glioblastoma have been reported to reveal the adenoid or epithelioid differentiation. The patients with NF1 are prone to develop malignant tumors including glioblastoma, but no cases representing adenoid glioblastoma associated with NF1 have been reported. This report is considered to be the first case of adenoid glioblastoma arising in a patient with NF1. The recognition of the existence of epithelial features of glioblastoma would be important in differential diagnosis of epithelioid tumors of the brain including metastatic carcinomas.

Adult↗

Adenoid Cystic Carcinoma of the lacrimal gland metastasising to the liver: report of a case.

BACKGROUND: Adenoid Cystic Carcinoma of the lacrimal gland is a rare tumour. Their aggressive behaviour, with a high-risk of local recurrence, and late distant spread of the tumour even after aggressive management has been reported. Metastasis to the liver is rare and when it occurs, it is usually part of widespread metastasis, and therefore surgical treatment is seldom considered. CASE PRESENTATION: We report a rare case of an isolated liver metastasis from a lacrimal gland adenoid cystic carcinoma 20 years after resection of the primary tumour. The patient presented with right upper quadrant pain radiating to the back and shortness of breath of 3 months duration. No local recurrence was detected during a 15 year follow-up with computerized tomography (CT) of the head. Abdominal CT scan demonstrated a solitary liver tumour with no other primary source, and the bone scan was normal. The patient was treated with an extended right hemihepatectomy. The histology revealed a predominantly cribriform tumour with focal areas of basaloid type metastatic lacrimal gland adenoid cystic carcinoma. CONCLUSION: This case illustrates the unpredictable behaviour of adenoid cystic carcinoma and the need for a life long follow up for these patients after treatment. The possibility of surgical resection for liver metastasis from adenoid cystic carcinoma should always be considered.

Journal Article↗

Endoscopic-guided adenoidectomy using a classic adenoid curette: a simple way to improve adenoidectomy.

A total of 13 adenoidectomies using a nasal endoscopic-guided transoral adenoid curette (not yet a published standardised method) were performed to treat snoring. Nasal endoscopy allows easy assessment of the size of the adenoids and improves the accuracy of the adenoidectomy. This technique is particularly useful for paediatric patients who have small oral cavities. The assessment and excision of the adenoids in these cases are often difficult. Using the nasal endoscope, the curette can be accurately inserted at the superior border of the adenoid, allowing the complete transoral removal of the main bulk of the adenoid tissue. All 13 patients showed considerably decreased snoring and improvements in the quality of sleep as reported by the parents and the patients. We believe that nasal endoscopic-guided transoral adenoidectomy is a viable alternative to classic adenoidectomy. This technique also has the advantage of using commonly available simple ear, nose, and throat instruments.

Adenoidectomy↗

Microbiology of the tonsils and adenoids in a pediatric population.

To investigate the microbial flora of the tonsils and adenoids, the core tissue from the tonsils and adenoids of 50 children undergoing tonsillectomy and adenoidectomy for either recurrent infection or airway obstruction was cultured aerobically and anaerobically, and the number of bacterial colonies was quantitated. The most common organisms isolated were alpha-hemolytic streptococci, nonpathogenic Neisseria species, Haemophilus species, Staphylococcus aureus, and Corynebacterium species. No anaerobes were identified. Bacterial isolates from the tonsils and adenoids were similar in number and frequency of occurrence. Potential pathogenic bacteria (Haemophilus species, S aureus, beta-hemolytic streptococci, and Streptococcus pneumoniae) were identified in 40 patients. Seventy-three percent of these patients shared a common pathogen in tonsil and adenoid tissue. Haemophilus species were recovered in 54% of patients and S aureus in 46%. No significant difference exists between the type and number of pathogens in patients undergoing adenotonsillectomy for recurrent infection or obstruction.

Adenoidectomy↗

Basaloid squamous carcinoma of the head and neck. Immunohistochemical comparison with adenoid cystic carcinoma and squamous cell carcinoma.

Basaloid squamous carcinoma (BSC) is a rare distinct variant of squamous cell carcinoma of the head and neck region. This entity may commonly pose diagnostic difficulties, especially on small biopsy material. We report the clinicopathological characteristics of 12 new cases and compare their immunohistochemical features with those of solid adenoid cystic carcinomas and conventional squamous cell carcinomas. Our results show that neoplastic BSCs and squamous cell carcinomas do not react to vimentin and S100 protein, while adenoid cystic carcinomas manifest both. The BSCs, however, are S100 protein-positive in intratumoral dendritic Langerhans' cells that are lacking in squamous cell and adenoid cystic carcinomas. Our findings indicate that the immunohistochemical differences between BSC and adenoid cystic carcinoma could assist in their differential diagnosis.

Aged↗

Cervical carcinoma with adenoid cystic pattern: a light and electron microscopic study.

Three cases of cervical carcinoma with an adenoid cystic pattern were studied by light and electron microscopy. All were found to be compatible with the histologic picture of adenoid cystic carcinoma in other body sites. Although there was some variability in the pattern among the tumors, areas of each exhibited a cribriform appearance characterized by small cells with sparse cytoplasm arranged around cystic gland-like lumina. Only one tumor displayed cylindromatous formations similar to those described by Billroth. Two of the tumors were associated with foci of squamous cell carcinoma while the third contained areas suggestive of such a component. Electron microscopic examination showed varied morphology of the cysts, manifested by true glandlike lumina, extracellular spaces containing replicated basement membrane or enclosed stroma. In view of the observed diversity in the light and electron microscopic morphology of adenoid cystic carcinomas of the cervix, it is apparent that this tumor is not a distinct histologic entity. Accordingly, it is recommended that the terminology "cervical carcinoma with adenoid cystic pattern" be utilized.

Adenocarcinoma↗

Basement membranes in adenoid cystic carcinoma. An immunohistochemical study.

Tissue samples from 30 patients with adenoid cystic carcinoma and 20 with adenocarcinoma of salivary gland origin were studied by immunohistochemical staining with specific antibodies to the four macromolecules that are present in normal basement membranes: type IV collagen, laminin, heparan sulfate proteoglycan, and entactin. In the adenoid cystic carcinoma samples, the four proteins were localized in different types of extracellular matrices in the tumor, namely pseudocystic spaces, hyaline stroma, and around tumor cell nests. The staining intensity was enhanced by pretreatment with hyaluronidase. The tumor cells of adenoid cystic carcinoma showed a tendency to proliferate with individual cells in contact with the basement membrane and to infiltrate through basement membrane-rich tissues, such as peripheral nerves, blood vessels, and skeletal muscles. In contrast, only circumferential staining of tumor cell nests was obtained in adenocarcinoma samples. The results suggest that adenoid cystic carcinoma is a tumor with affinity for basement membranes, and this basic feature is reflected in its histology and presumably in its biologic behavior. Immunostaining with antibodies to basement membrane proteins appears to be useful for differential diagnosis of some types of these two carcinomas.

Adenocarcinoma↗

Rearrangement of 9p13 as the primary chromosomal aberration in adenoid cystic carcinoma of the respiratory tract.

Two adenoid cystic carcinomas, one of the nasal cavity, the other a bronchial tumor, were cytogenetically analyzed. The former had a t(6;9)(q21-22;p 13-21) as the sole karyotypic abnormality. The latter had two related abnormal clones, resulting in the mosaic karyotype 46,XY,t(9;17)(p13;p13)/46,Y,t(X;6)(p22;q23),t(9;17)(p13;p13). The karyotypic profiles of the two cases, the only respiratory tract adenoid cystic carcinomas that have been cytogenetically characterized, differ little from those of previously reported adenoid cystic carcinomas of the major salivary glands, underscoring the fundamental biologic similarity among these tumors even when they develop from different structures and in different anatomical sites and organs. Because in the second case the t(9;17) obviously must have preceded the t(X;6), we conclude that both tumors had rearrangement of 9p13 as the primary cytogenetic change. The data thus add to the evidence that 6q changes are frequent, albeit at least sometimes secondary, aberrations in malignant salivary gland tumors. A subset of adenoid cystic carcinomas instead have rearrangement of 9p as the primary, and presumably pathogenetically essential, abnormality.

Adult↗

Detection of adenoidal hypertrophy using acoustic rhinomanometry.

Adenoidal hypertrophy is the commonest cause of nasal obstruction in the pediatric population. It may cause marked morbidity as regards respiratory physiology, facial growth and middle ear function. Determination of adenoidal presence and size is not easy. Nasal endoscopy and radiology are the most accepted modes of diagnosis and each has its disadvantages. We have used acoustic rhinometry to determine the size of adenoids. Changes in nasal volume and resistance were recorded and an easy formula was devised to determined adenoid size. This technique is easy, non-invasive and reproducible with a 93.5% predictive value.

Acoustics↗

A suggested clinical score to predict the severity of adenoid obstruction in children.

Chronic nasal obstruction in children is a very common disorder. Obstructing adenoid is usually the first to blame. Though the clinical assessment is essential, it is often considered unreliable or insufficient. We conducted a prospective clinical study to validate a clinical score predicting the severity of adenoid obstruction in symptomatic children. The clinical score (CS) included mouth breathing, snoring, restless sleep, frequent waking-up at night and obstructive breathing during sleep. Each item received a score of 0 or 1. The palatal airway was evaluated on a lateral nasopharyngeal x-ray. The degree of obstruction was assessed intra-operatively by a laryngeal mirror using a 3-grade scale. The volume of each adenoid specimen was measured. Eighty-six patients were enrolled, 51 boys and 35 girls, aged 13-181 months (mean 52, median 45). The CS correlated very well with the intra-operative findings (p < 0.01) and with the degree of palatal airway obstruction (p < 0.05) but not with the volume of the adenoid removed (p > 0.05). The CS was higher in children younger than 3 years (CS > 3 in 85.7% vs. 29.2%), having more frequent obstructive breathing during sleep (71.43% vs. 21.54%). A CS of three or higher, predicted severe obstruction in 96.5% of patients, as detected intra-operatively. The suggested CS is simple to use and is highly reliable in identifying children in need for adenoidectomy, in the context of normal anterior rhinoscopy and tonsils less than grade three.

Adenoids↗

Keratin 14 immunoreactive cells in pleomorphic adenomas and adenoid cystic carcinomas of salivary glands.

Our recent study of developing myoepithelial cells (MECs) in rat salivary glands demonstrated that developing MECs begin to express alpha-smooth muscle actin (alphaSMA) first and, thereafter, keratin 14. Therefore, it is unlikely that duct basal cells expressing keratin 14 alone are immature or undifferentiated MECs. In this study we carried out immunohistochemistry of pleomorphic adenomas and adenoid cystic carcinomas including normal salivary glands using monoclonal antibodies to keratin 14, smooth muscle proteins and keratin 19. The smooth muscle proteins examined included alphaSMA, h-caldesmon and h1-calponin; h1-calponin was observed in keratinocytes and nerve fibers, indicating that the protein is not specific to smooth muscle, whereas alphaSMA and h-caldesmon turned out to be highly specific markers for smooth muscle cells in normal tissues. In normal glands, MECs were positive for both keratin 14 and smooth muscle proteins (alphaSMA and h-caldesmon). Non-MEC cells were essentially devoid of smooth muscle proteins. Non-MEC duct basal cells expressed keratin 14 with or without keratin 19, and luminal cells keratin 19 with or without keratin 14. This suggests that the keratin 14-positive, smooth muscle proteins-negative duct basal cells are luminal cell progenitors. Luminal cells in tubular structures of both tumors were positive for keratin 19 with or without keratin 14. Nonluminal peripheral cells of pleomorphic adenomas were mostly positive for keratin 14, and a small fraction of them expressed smooth muscle proteins. Conversely, peripheral cells of adenoid cystic carcinomas were mostly positive for smooth muscle proteins, and some of them expressed keratin 14. These results strongly suggest (1) that the luminal cell progenitors transform into major constituents of pleomorphic adenoma cells with keratin 14 but not smooth muscle proteins, and (2) that the peripheral cells of adenoid cystic carcinoma are derived from undifferentiated MECs. Solid structures of pleomorphic adenomas were formed by proliferation of the peripheral cells. MECs were observed only occasionally in the periphery. Solid and cribriform structures of adenoid cystic carcinomas were formed by proliferation of the luminal cells. MECs were observed in the periphery and around the pseudocyst.

Actins↗

Adenoid basal carcinoma of the uterine cervix: a case report with ultrastructural findings.

Adenoid basal carcinoma of the uterine cervix is a rare tumor with a favorable prognosis. A case of adenoid basal carcinoma (ABC) of the uterine cervix was studied using light and electron microscopy. The patient was a 74-year-old Japanese woman who had undergone hysterectomy due to cervical intraepithelial neoplasia 3. Incidentally, ABC was found in the resected uterus. The tumor cells made small nests and infiltrated the cervical portion of the uterus. In the nests, glands, cribriform patterns with glandlike structures, and squamous differentiation were seen. Immunohistochemically, the glandlike structures were positive for laminin and type IV collagen. Ultrastructurally, the tumor cells had irregular nuclei, scanty cytoplasm, and cribriform patterns in which glandlike structures were covered with basal lamina. No myoepithelial differentiation of the tumor cells was seen. These findings suggest a similarity between adenoid basal carcinomas and adenoid cystic carcinomas. Furthermore, both tumors are considered to originate in the reserve cells of the uterine cervix. Because their outcomes are different, they should be distinguished from each other.

Aged↗

Adenoid cystic carcinoma arising from the lower eyelid.

BACKGROUND: Primary cutaneous adenoid cystic carcinoma is one of the rarest eyelid tumors. CASE: A 39-year-old man presented with a small subcutaneous induration in his left lower eyelid close to the lower lacrimal punctum. OBSERVATIONS: Under a clinical diagnosis of chalazion, the eyelid induration was extracted surgically via the palpebral conjunctiva. Histopathological examination of the extracted tumor revealed proliferation of basaloid cells with a prominent cribriform pattern containing Alcian blue-positive and periodic acid Schiff-positive material, leading to a diagnosis of adenoid cystic carcinoma. The patient subsequently underwent extended radical excision including the lacrimal sac. No recurrence was observed during 20 months after surgery. CONCLUSIONS: Adenoid cystic carcinoma should be considered as a differential diagnosis of eyelid tumors simulating chalazion. Adenoid cystic carcinoma in the eyelid may have a more favorable prognosis than that in the lacrimal gland.

Adult↗

A case of uterine cervical adenoid cystic carcinoma: immunohistochemical study for basement membrane material.

BACKGROUND: Adenoid cystic carcinoma is a rare neoplasm of the cervix. Only two reports of immunohistochemical studies for basement membrane material in adenoid cystic carcinoma of the cervix have been reported. CASE: An 80-year-old Japanese woman complained of atypical vaginal bleeding and underwent removal of a cervical polyp; the biopsy specimen revealed a solid variant of adenoid cystic carcinoma. The tumor was composed of nests and nodules of small carcinoma cells, and there were few characteristic cribriform patterns. Immunohistochemical findings for type IV collagen and laminin revealed intercellular cylinders composed of basement membrane material in the solid area without a cribriform pattern. CONCLUSION: The immunohistochemical finding of intercellular cylinders that reacted for type IV collagen was useful for the diagnosis of a solid variant of adenoid cystic carcinoma.

Aged↗

Lymphocyte subsets in human adenoids and tonsils. Rosette formation, alpha-naphthyl acetate esterase cytochemistry, monoclonal antibodies and peanut lectin reactivity.

The distribution of mononuclear cell subsets has been studied in human adenoids, tonsils and peripheral blood (PB) by evaluating the presence of surface immunoglobulins, E-rosette formation, receptors for IgG Fc and for complement, alpha-naphthyl acetate esterase (ANAE) cytochemistry, reactivity with peanut lectin (PNA) and with monoclonal antibodies (McAb) (OK panel). Adenoids and tonsils, compared to PB, contain (1) fewer macrophages and T cells but more B cells; (2) higher proportions of ANAE negative, complement receptors and Ia-like antigens bearing T lymphocytes; (3) higher percentages of cells reacting with the McAbs OKT9 and OKT10 ("immature" lymphoid cells). In both adenoids and tonsils, clusters, formed by a central heavily ANAE stained interdigitating cell surrounded by lymphocytes with a sickle-shaped ANAE reaction, were found. Analogous clusters have been previously described in mice and human thymus. Two major hypotheses could be put forward: (1) adenoids and tonsils contain "immature" lymphoid cells undergoing education process, or (2) the above organs contain lymphocytes activated by a constant exposure to bacterial antigens or mitogens.

Adenoids↗

The role of oxidants and antioxidants in chronic tonsillitis and adenoid hypertrophy in children.

OBJECTIVE: To determine the possible role of oxidants and antioxidants in the pathogenesis of chronic tonsillitis (CT) and adenoid hypertrophy (AH) in children. METHODS: Randomized, prospective, controlled. The study group was made up of children with chronic tonsillitis and adenoid hypertrophy who are to undergo tonsillectomy and adenoidectomy. The control group was constructed with otherwise healthy children with normal ENT examination. The blood levels of antioxidants (retinol, beta-carotene, alpha-tocopherol, laycopene, ascorbic acid, superoxide dismutase, glutathione peroxidase, GSH) and peroxidation products (malondialdehyde) were determined before and 1 month after the operation in the study group and once only in the control group. These antioxidants and peroxidation products were also measured in the tonsil and adenoid tissue that were obtained during operation. RESULTS: In the study group, the blood levels of antioxidants and oxidant before and after the operation were significantly different when compared to the control group (P < 0.05). In the study group, the blood antioxidant levels increased and oxidant level decreased significantly after the operation (P < 0.05). These levels after the operation never reached those of the control group. CONCLUSIONS: Oxidants and antioxidants played a significant role in the pathogenesis of chronic tonsillitis and adenoid hypertrophy in children. These children are under significant oxidative stress. Tonsillectomy and adenoidectomy significantly decreased the oxidative stress in these patients, but could not normalize it completely. Further studies are necessary to evaluate their possible therapeutic role in preventing recurrent tonsillitis and treating postoperative patients to help normalize their blood levels of antioxidants.

Adenoidectomy↗