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PubMedDate not supplied

Adenoid cystic carcinoma metastatic to the lung. Report of a case diagnosed by fine needle aspiration biopsy cytology.

Cytologic examination of a fine needle aspiration (FNA) biopsy specimen served to diagnose a lung metastasis in a patient with an adenoid cystic carcinoma primary in a minor salivary gland of the hard palate. The aspiration cytologic features of the metastatic adenoid cystic carcinoma were similar to those of primary adenoid cystic carcinoma, including uniform tumor cells with scant cytoplasm surrounding transparent, mucoid spherical bodies. FNA biopsy cytologic diagnosis of metastatic adenoid cystic carcinoma is accurate, particularly if mucoid spherical bodies are present.

Biopsy, Needle↗
PubMed1987

The role of immunoglobulins in allergic disease: IgE and IgG4 immunofluorescent study of adenoid tissue.

Upper airway allergy is a common problem in children. The most frequent tissue removed from children is adenoid tissue. Although conventional stains offer little help in characterization of the allergic response in this tissue, immunohistologic assessment does offer the opportunity to reveal immunoreactants present. Adenoid tissue from 91 allergic and nonallergic children was examined by a dual immunofluorescent method to detect mast cell membrane bound IgE and IgG4. Positive mast cell membrane staining was seen with IgE (FIEMC) but not with IgG4 in adenoid tissue from allergic children. Numerous IgG4 plasma cells were often seen in close relationship to FIEMC in adenoid stroma where blocking function of IgG4 may take place. False-positive FIEMC patients may represent transient or infrequent encounters with allergens. Disparate clinical allergy and tissue FIEMC status may also reflect different genetic control of IgE regulation and antigen (allergen) recognition.

Adenoids↗
PubMed1982

Correlation between the sensitivity of the ciliary beat frequency of human adenoid tissue and chicken embryo tracheas for some drugs.

The effects of benzalkonium chloride, chlorbutol,xylometazoline and naphazoline on the ciliary beat frequency of human adenoids and chicken embryo tracheas have been determined and compared. Chlorbutol 0.5% appeared to arrest ciliary motion in both tissues within 5 minutes. Rinsing with Locke Ringer solution (LR) restored the ciliary motion almost completely in both cases. Benzalkonium chloride 0.006% +EDTA 0.1% decreased the ciliary beat frequency 35% for the human tissues and 50% for the chicken tissues after a contact of 20 minutes. In both cases the frequency hardly changed after rinsing with LR. Naphazoline nitrate 0.1% and xylometazoline HCl 0.05% have reversible effects on the ciliary beat frequency of both human adenoids and chicken embryo tracheas. Cilia of human adenoids appeared to be more sensitive for xylometazoline than for naphazoline; whereas cilia of chicken embryo tracheas were more affected by naphazoline than by xylometazoline. The results with human adenoids and chicken embryo tracheas show a correlation (correlation coeff. = 0.82, p less than 0.005). In the initial response the differences in sensitivity to preservatives and drugs were in many cases statistically significant, but the final effects were similar.

Adenoids↗
PubMed1994

The effect of hypertrophic adenoids and tonsils on the development of posterior crossbite and oral habits.

There are a number of studies in the literature, that associate nasopharyngeal airway obstruction, as a result of adenoid enlargement, to the development of skeletal and dental abnormalities. However, the etiologic role of hypertrophied adenoids and tonsils in developing an aberrant dentofacial growth is not clear, yet. The present investigation attempted to study the incidence of maxillary posterior crossbite and oral habits, in a sample of 120 children, that displayed hypertrophied adenoids with or without enlarged tonsils, and underwent adenoidectomy. An attempt was also made to relate the presence of crossbite to the severity of upper respiratory airway obstruction. The severity of airway obstruction was assessed using radiographic and surgical criteria. A lateral cephalometric radiograph was obtained and studied for each patient. Results indicated, that 47% of the children examined, had developed a posterior crossbite. The presence of crossbite was high in children with severe airway obstruction, particularly in those with hypertrophied adenoids and tonsils. On the contrary, most of the children with a posterior crossbite did not have a history of pacifier or finger sucking. It was also concluded, that the study of a lateral cephalometric radiograph can be a valuable diagnostic method in the evaluation of children with upper airway obstruction.

Adenoids↗
PubMed1995

"Adenoid cystic" and basaloid carcinomas of the ovary: evidence for a surface epithelial lineage. A report of 12 cases.

Twelve ovarian neoplasms resembling salivary gland carcinomas and cutaneous basal cell carcinomas were studied and assigned to two groups: six with an exclusive or conspicuous component resembling adenoid cystic carcinoma and six with an exclusive or predominant component resembling basal cell carcinoma. The patients whose tumors simulated an adenoid cystic carcinoma presented at 60 to 78 (mean, 67) years of age. The adenoid cystic-like pattern was present in the primary ovarian tumor in five cases and four of these tumors had an additional surface epithelial-stromal component (serous adenocarcinoma in two, endometrioid adenocarcinoma in one, and mixed clear cell/endometrioid adenocarcinoma in one). The one patient with a Stage Ia tumor was free of disease at 37 months. Of the four patients whose tumors were Stage IIIc, two died of tumor at 13 and 123 months, respectively; another was alive with tumor at 27 months; and one was lost to follow-up. In the sixth case, an adenoid cystic-like pattern was present in a recurrent tumor in a patient from whom an ovarian endometrioid adenocarcinoma had been excised 11 years earlier. The patients whose carcinomas were predominantly or entirely basaloid presented at 19 to 65 (mean, 49) years of age. Three of these tumors had prominent squamous differentiation and gland formation, suggesting a relation to endometrioid carcinoma; three other tumors had an ameloblastoma-like pattern, with focal squamous differentiation in one, and a minor component of endometrioid adenocarcinoma adjacent to another. The four patients in the basaloid carcinoma group with Stage Ia tumors were alive without tumor at 16 to 71 (mean, 35) months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1996

Detection of Haemophilus influenzae in adenoids and nasopharyngeal secretions by polymerase chain reaction.

Haemophilus influenzae in the nasopharynx is thought to be related to the pathogenesis of otitis media with effusion (OME). However, the positive rate measured by the conventional culture method is not high enough for bacterial infection to be considered the chief pathogenic factor. Polymerase chain reaction (PRC) and the conventional culture method were applied to detect H. influenzae in the adenoids and nasopharyngeal secretions of 17 children with OME (2 to 7 years of age). The percentage of P6-positive adenoid samples was 82.4% while 70.6% were culture positive. In nasopharyngeal secretions, 88.2% were P6-positive and 64.7% were culture positive. All samples in which H. influenzae was cultured were positive with PCR. The positive rate was significantly greater with PCR than with the culture method, and it showed a significant concordance between adenoids and nasopharyngeal secretions (p = 0.0027). These findings suggest that the presence of H. influenzae in the nasopharynx is more common in children with OME than previously reported, and that H. influenzae in adenoids might play an important role in OME.

Adenoids↗
PubMed1996

Adenoid lymphocyte responses to outer membrane protein P6 of nontypable Haemophilus influenzae in children with and without otitis media.

The cellular immune responses to nontypable Haemophilus influenzae in adenoids were determined in children by measuring lymphocyte blast transformation and antibody secretion in response to the P6 outer membrane protein. In the lymphocyte transformation assay, stimulation index of adenoid lymphocytes stimulated by P6 in otitis children (2.34 +/- 0.25) was significantly lower than that in non-otitis children (3.91 +/- 0.64, p <0.05). The number of IgM as well as IgA secreting cells after 8 days' culture with P6 were significantly smaller in otitis children (IgM: 7,534 +/- 2,843/10(6) lymphocyte; IgA: 1,573 +/- 620/10(6) lymphocyte) than those in non-otitis children (IgM: 12,994 +/- 2,533, p <0.05; IgA: 2,828 +/- 528, p <0.05). These data suggest that P6 protein is a target for the cellular immune response of the adenoid, and failure of adenoid lymphocytes to recognize it as a specific immunogen may be one of the causes of recurrent otitis media.

Adenoids↗
PubMed1996

Expression of adhesion molecules on the microvasculature of the pharyngeal tonsil (adenoid).

We have examined the vasculature of 12 human adenoids and the expression and distribution of four endothelial adhesion molecules, ICAM-1, VCAM-1, P-selectin and E-selectin, in tissue sections using histology, immunocytochemistry and immunoelectron microscopy (IEM). The connective tissue septa and septula contained arterioles, veins and efferent lymphatics. Branches of arterioles supplied lymphoid follicles and divided into sub- and intraepithelial capillary plexuses which drained into interfollicular venules, mostly high endothelial venules (HEV), before joining larger veins. No afferent lymphatics were observed entering the adenoid. Although ICAM-1 was widely distributed in the tissue, it was preferentially expressed on luminal aspects of HEV. E-selectin was found only in a few areas on HEV and subepithelial capillaries, whereas P-selectin was strongly expressed on segments of HEV, adjacent small venules and a few follicular capillaries. IEM showed the localisation of VCAM-1 on the components of the perivascular sheath, but not on the endothelium, of some HEV and capillaries. Its strongest expression was on follicular dendritic cells (FDC). These findings showed that in addition to HEV, lymphocyte-binding molecules are expressed on other segments of adenoid vasculature and their distribution and intensity of expression varies. In the non-inflamed adenoid, the VCAM-1 does not seem to participate in the adhesive mechanism of recirculating lymphocytes to the endothelium which, in this study, lacked the expression of VCAM-1 in all vessels.

Adenoids↗
PubMed1995

Fine-needle aspiration cytology of adenoid (acantholytic) squamous-cell carcinoma.

Adenoid squamous-cell carcinoma (ASCCa) is an uncommon cancer which occurs most frequently in the skin of the head and neck region of elderly, sun-exposed individuals. Histologically, ASCCa is characterized by gland-like, "adenoid" cell groups with a central, detached acantholytic cellular component and an intact peripheral rim of cells. The cytological features of five fine-needle aspiration cytology (FNAC) samples from four patients with primary or metastatic ASCCa are presented. These were assessed for features which would allow distinction of this variant from conventional squamous carcinoma. The adenoid component was represented in FNAC by intact, sometimes three-dimensional cell groups simulating glandular structures. Also present were cells in short chains of two or three in single cell files and scattered, individual dyskeratotic cells. Individual cells had rounded, accentuated borders, cytoplasmic keratinization, and often pyknotic nuclei, representing acantholytic cells from the adenoid "lumens." Features of malignancy, including cellular atypia and increased mitotic rate, were present allowing for distinction between ASCCa and benign acantholytic processes such as pemphigus.

Aged↗
PubMed2006

High frequency of FGFR3 mutations in adenoid seborrheic keratoses.

FGFR3 germline mutations cause autosomal dominant skeletal disorders including achondroplasia, thanatophoric dysplasia, severe achondroplasia with developmental delay and acanthosis nigricans, and Crouzon syndrome. Somatic mutations of FGFR3 have been identified in bladder cancer, multiple myeloma, and other neoplasms. FGFR3 mutations have also been detected in 40% of seborrheic keratoses (SKs) of the hyperkeratotic and acanthotic subtype, which are very common benign skin tumors. Using a multiplex SNaPshot assay that covers 11 activating FGFR3 mutations, we investigated a series of 27 SKs of the adenoid subtype. Mutations were detected in 23 of 27 (85%) adenoid SKs. R248C mutations were the most frequent mutation type. In two SKs, the A393E mutation was found, which has not been described in acanthotic and hyperkeratotic SKs so far. Three adenoid SKs displayed two simultaneous FGFR3 mutations. Adenoid SKs seem to be characterized by a higher frequency of FGFR3 mutations than hyperkeratotic and acanthotic SKs. The mechanism for the high rate of somatic FGFR3 mutations in these benign skin tumors remains elusive, but UV light exposure may play a potential role, especially in the R248C mutations.

Aged↗
PubMed1986

Human adenoid organ culture: a model to study the interaction of influenza A with human nasopharyngeal mucosa.

Previous studies of infections with influenza A in animal models have stressed the tropism of this virus for the upper respiratory tract. To assess the interaction of influenza A virus with human respiratory tissue, we maintained adenoids, consisting of ciliated epithelium with underlying lymphoid follicles, in organ culture. When the organ cultures were inoculated with wild-type influenza A/Alaska (H3N2), epithelial damage and migration of inflammatory cells from the follicles into the lamina propria were seen. Growth of the virus and ciliary damage in infected organ cultures from seronegative donors were significantly greater than that seen in organ cultures from seropositive donors. Adenoidal lymphocytes were then studied to determine which factors might modulate infectivity. Specific in vitro production of antibody to influenza A/Alaska was demonstrated by adenoidal lymphocytes from seropositive donors, whereas lymphocytes from seronegative donors did not produce antibody. The human adenoid organ culture provides an attractive model to study the pathogenesis of influenza A infections and the resultant local immune response.

Antibodies, Viral↗
PubMed2002

Co-existent carcinosarcoma and adenoid basal carcinoma of the uterine cervix and correlation with human papillomavirus infection.

A case of carcinosarcoma associated with an adenoid basal carcinoma of the uterine cervix in an 84-year-old woman is described. The tumor formed a pelvic mass, and total hysterectomy with bilateral salpingo-oophorectomy was performed. The tumor was 17 cm in maximal dimension, arose in the posterior wall of the uterine cervix, and had a solid and cystic, focally myxoid sectioned surface. The tumor was composed of keratinizing squamous cell carcinoma and a mostly nonspecific sarcomatous component with focal chondrosarcomatous differentiation. Multiple foci of adenoid basal carcinoma were observed in the adjacent cervical wall. The HPV L1 gene was detected by PCR in each of the carcinomatous and sarcomatous components of the carcinosarcoma and the adenoid basal carcinoma. To our knowledge, this is the fifth case of coexisting carcinosarcoma and adenoid basal carcinoma of the uterine cervix in the English language literature.

Aged↗
PubMed1997

Adenoid basal carcinoma of the cervix uteri: a case report.

We report a rare case of adenoid basal carcinoma of the uterine cervix, unexpectedly found in a uterus resected for the treatment of cervical intraepithelial neoplasia (CIN) 3. The patient was a 47-year-old Japanese female. She received a total abdominal hysterectomy under a diagnosis of CIN 3 of the cervix. Grossly, there were no significant findings in the surgical specimens. Microscopically, in seven of the 12 blocks of the cervix examined, scattered small nests of uniform small cells, which extended 4 mm below the epithelial surface, with dark nuclei and scant cytoplasm were observed. Peripheral palisading as well as the formation of gland-like or acinar structures were noted. The latter were positive for mucicarmine. Stromal reaction was not obvious. There were also foci of squamous differentiation in some portions of the small nests. Occasional mitoses as well as large atypical cells were also seen in this area. Immunohistochemically, the foci of squamous differentiation were positive for carcinoembryonic antigen. The epithelial surface in other portions showed CIN 3 with crypt extension. Distinction between adenoid basal carcinoma of the cervix and other diseases, such as adenoid cystic carcinoma and squamous cell carcinoma with basaloid features, is important for clinical management because the clinical behavior of adenoid basal carcinoma is less malignant.

Carcinoma↗
PubMed2006

Adenoid basal lesions of the uterine cervix: evolving terminology and clinicopathological concepts.

The epithelial proliferations that are designated adenoid basal carcinoma (ABC) in the current classification from the World Health Organization represent <1% of all cervical malignancies. These lesions may be associated, and occasionally show morphologic transitions with, conventional cervical malignancies. The determination of the precise frequency with which these so-called ABCs show this association is hampered by the inherent selection bias in the reported cases. However, this frequency appears to be substantial (>15%). The biologic course of ABCs that are associated with separate malignancies is largely dependent on the clinicopathologic parameters of the associated malignancies. Morphologically pure lesions, in contrast, have largely been associated with favorable patient outcomes, as none of the 66 reported patients have experienced tumor recurrence, metastases or tumor-associated death, irrespective of the modality of treatment. Although the finding of genome integrated high-risk human papillomavirus (HPV) types and p53 alterations in adenoid basal lesions (ABL) argue in support of their neoplastic nature, we identified no lines evidence that suggest an inherent malignancy for morphologically pure lesions. The finding of morphologic transitions between ABLs and conventional malignancies and shared HPV types in these areas, suggest that ABLs have some malignant potential. However, the precise magnitude of this potential is not readily quantifiable and should not dictate the management of morphologically pure lesions that are entirely evaluable. ABLs continue to occupy a unique position in human oncology in which the term carcinoma (without an in-situ suffix) is applied to a tumor that has not been shown to recur, metastasize or cause death. We concur with a previous proposal that the term ABC should be discarded and replaced with Adenoid Basal Epithelioma (ABE). In our opinion, there is insufficient evidence at present time to expose patients with morphologically pure lesions to the ominous implications--social, psychological, medical, financial--of a "carcinoma" diagnosis. Morphologically impure lesions should not be designated ABC or ABE. Furthermore, given the uncertainties regarding the frequency with which ABE are associated with separate malignancies, we suggest that the ABE designation only be applied when the tumor in question is entirely evaluable e.g in a hysterectomy specimen or in an excisional biopsy with negative margins. Otherwise, the generic designation Adenoid Basal Tumor is preferable. This approach strikes an appropriate balance between the need to prevent over-treatment of pure lesions on one hand, and the need to ensure that the lesions are indeed pure on the other.

Journal Article↗
PubMed1989

The tonsil and adenoid controversy.

This paper will review the anatomy, histology, immunology, bacteriology, indications, complications, and trends in modern tonsil and adenoid surgery. Information on tonsils and adenoids, both in their normal and abnormal states, has proliferated over the last two decades. A considerable variation in opinion remains on the subject. Historical fluctuations in the indications for tonsil and adenoid surgery have resulted in swings in the quantity of surgery performed. This paper will attempt to bring contemporary information together to provide reasonable guidelines for management of disease tonsils and adenoids.

Adenoidectomy↗
PubMed1998

Adenoid cystic carcinoma of the lacrimal gland simulating a dermoid cyst in a 9-year-old boy.

Adenoid cystic carcinoma of the lacrimal gland is a malignant neoplasm that is generally found in adults and is usually managed by orbital exenteration and supplemental external beam irradiation or chemotherapy. A recent report has suggested that the tumor may have a less malignant course in children. We describe a case of adenoid cystic carcinoma of the lacrimal gland that simulated a dermoid cyst clinically and radiographically in a 9-year-old boy. The patient was treated with local surgical resection of the mass, followed by orbital plaque brachytherapy. Based on a review of the literature and our recent experience, the advisability of a more conservative approach to this tumor in selected cases is discussed. Although no prognostic conclusions can be drawn on the basis of a single case report with short follow-up, the relatively earlier detection of this tumor made possible by modern orbital imaging studies may allow total removal at an earlier stage and prevent orbital exenteration in a patient with normal vision. Recent developments suggest that there may be a basis for reassessing the advisability of a radical approach to the management of adenoid cystic carcinoma of the lacrimal gland in selected cases.

Brachytherapy↗
PubMed2006

Proton beam radiation therapy for skull base adenoid cystic carcinoma.

OBJECTIVE: To determine the treatment outcome and prognostic factors in patients with adenoid cystic carcinoma of the skull base treated with proton beam radiation therapy. DESIGN: Retrospective analysis. SETTING: Massachusetts General Hospital, Massachusetts Eye and Ear Infirmary, and Harvard Medical School, Boston. PATIENTS: From 1991 to 2002, 23 patients with newly diagnosed adenoid cystic carcinoma with skull base extension were treated with combined proton and photon radiotherapy. There was tumor involvement of the sphenoid sinus in 61% of patients (14), nasopharynx in 61% (14), clivus in 48% (11), and cavernous sinus in 74% (17). The extent of surgery was biopsy alone in 48% (11), partial resection in 39% (9), and gross total resection with positive margins in 13% (3). The median total dose to the primary site was 75.9 cobalt-gray equivalent. The median follow-up of all surviving patients was 64 months. MAIN OUTCOME MEASURES: Locoregional control and disease-free survival and overall survival rates. RESULTS: Tumors recurred locally in 2 patients at 33 and 68 months, respectively. No patients developed neck recurrence. Eight patients had distant metastasis as the first site of recurrence. The local control rate at 5 years was 93%. The rate of freedom from distant metastasis at 5 years was 62%. The disease-free and overall survival rates at 5 years were 56% and 77%, respectively. In multivariate analysis, significant adverse factors predictive for overall survival were change in vision at presentation (P = .02) and involvement of sphenoid sinus and clivus (P = .01). CONCLUSIONS: High-dose conformal proton beam radiation therapy results in a very encouraging local control rate in patients with adenoid cystic carcinoma of the skull base. Changes in vision at presentation and tumor involvement of the sphenoid sinus and clivus are important prognostic factors.

Adult↗
PubMed1993

Neutron radiotherapy for adenoid cystic carcinoma of the head and neck.

Achieving local control in patients with advanced adenoid cystic carcinoma continues to be a therapeutic challenge. From 1984 to 1990, we treated 34 patients with advanced adenoid cystic carcinoma of the head and neck with fast neutron radiation. Patients treated for minimal microscopic disease following surgery were not included in this study. Neutron radiotherapy achieved 5-year actuarial local control and locoregional control rates of 76% and 63%, respectively. Five-year actuarial overall survival and disease-specific survival rates were 65% and 93%, respectively. Eighty-one percent (17/21) of patients treated with neutron therapy alone and 100% (13/13) of the patients treated with neutron therapy and surgery achieved local control. All seven patients with paranasal sinus malignant neoplasms achieved local control. The success achieved in this prognostically unfavorable population affirms the important role of neutron radiotherapy in the treatment of adenoid cystic carcinoma.

Adolescent↗