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PubMed1999

Dedifferentiation occurring in adenoid cystic carcinoma of the tongue.

A 61-year-old man came to the University of Granada School of Dentistry complaining of a mass involving his ventral tongue. Histopathologic examination of the excised specimen showed adenoid cystic carcinoma in which cribriform and tubular patterns were observed, juxtaposed with an undifferentiated carcinoma, large-cell type. No cervical lymph node metastasis was present, and the patient is alive and free of disease 5 years after treatment. To our knowledge, no similar cases have been reported thus far, though other salivary gland malignancies have been described in association with undifferentiated carcinoma, especially in the parotid gland. These neoplasms have been highly aggressive, and the adequacy of the primary surgical resection may be critical in determining the ultimate prognosis and survival.

Carcinoma, Adenoid Cystic↗
PubMed2004

Assessment of p63 expression in the salivary gland neoplasms adenoid cystic carcinoma, polymorphous low-grade adenocarcinoma, and basal cell and canalicular adenomas.

PURPOSE: The purpose of this study was to determine the extent of p63 immunoreactivity in the malignant salivary gland neoplasms adenoid cystic carcinoma (ACC) and polymorphous low-grade adenocarcinoma (PLGA) and to compare this to the expression of this marker in the benign salivary gland tumors canalicular adenoma and basal cell adenoma. Few studies on the expression of p63 in head and neck salivary gland tumors have been published to date. P63, a selective immunohistochemical marker of basal/stem cells of stratified epithelium and of myoepithelial cells, is a p53 homologue that plays an essential role in both morphogenesis of epidermis and limb development. P63 immunoreactivity has been demonstrated in squamous cell and urothelial carcinomas. It is generally absent in most nonsquamous cell carcinomas. Study design Formalin-fixed paraffin-embedded sections from 49 salivary gland neoplasms, representing 6 canalicular adenomas, 11 basal cell adenomas, 17 PLGA and 15 ACC accessioned from 1989 to 2002 by the Department of Pathology, Long Island Jewish Medical Center, New Hyde Park, NY, were stained with an anti-p63 monoclonal antibody. RESULTS: Nuclear p63 reactivity was uniformly positive in PLGA (17/17, 100%). Positive reactivity was also identified in the majority of cases of ACC (13/15, 87%), primarily in the nonluminal myoepithelial-like cells surrounding luminal cells. Canalicular adenoma did not exhibit any p63 immunoreactivity. All basal cell adenomas of parotid origin stained strongly for p63, with staining localized to the peripheral tumor cells situated adjacent to the connective tissue stroma. None of the basal cell adenomas originating in the upper lip stained with p63. In native adjacent salivary gland tissue, p63 reactivity was identified focally in the nuclei of myoepithelial and basal duct cells. CONCLUSIONS: P63 is strongly expressed in basal cell adenoma of parotid origin, and in ACC and PLGA. Canalicular adenoma did not demonstrate p63 staining, consistent with this tumor's putative luminal ductal cell differentiation. Our results suggest that the neoplastic cells in PLGA may represent either a population of p63-positive epithelial stem/reserve cells similar to the basal cells of stratified epithelium, or modified myoepithelial cells. Given the staining pattern of the tumors examined, p63 does not appear to be an ideal marker for distinguishing between ACC, PLGA, and basal cell adenoma.

Adenocarcinoma↗
PubMed2001

The risk of adenoid hypertrophy in children with allergic rhinitis.

BACKGROUND: Adenoid hypertrophy (AH) may cause significant morbidity in children but its relationship to allergic rhinitis (AR) has not been studied. OBJECTIVE: To determine the risk factor of AH in patients with AR. METHODS: We studied 315 children (ages 1 to 18 years) who had AH and AR. We compared them with 315 age-matched controls who had AR alone. To identify risk factors, they were divided into four groups according to age and clinical parameters, including the prevalence of otitis media, sinusitis, lower respiratory infection, exposure to smoking, sleep disorders, use of antihistamine/decongestants, and results of allergy skin testing. RESULTS: The prevalence of upper or lower respiratory infections was higher in the group with AR and AH, but not in all age groups. A high prevalence of exposure to smoking and skin test reactivity against house dust mites were found in both groups. However, the prevalence of positive reactivity to molds was significantly higher in the group with AH and AR (P ranged from 0.013 to <0.0001 and the relative risk ranged from 1.609 to 2.375). Further, the risk of AH was positively correlated with number of skin test reactivity to mold spores (P ranged from 0.0035 to 0.0001). Positive skin test reactivity to animal danders or seasonal allergens failed to predict the risk of AH. CONCLUSIONS: Sensitivity to mold allergens is an important risk factor for AH in children with AR; therefore, early prevention of exposure to molds may help reduce occurrence of AH.

Adenoids↗
PubMed2000

Immunohistochemical evaluation of estrogen and progesterone receptors in adenoid cystic carcinoma of salivary gland origin.

Adenoid cystic carcinoma (ACC) is a malignant tumor of salivary gland origin, which is characterized by a high rate of local recurrence and distant metastasis even after aggressive surgical treatment. In several studies using various immunohistochemical techniques, estrogen and progesterone receptor (ER and PgR) proteins in salivary gland ACC have been identified and the possible use of endocrine therapy as a treatment modality suggested. On this basis, 27 samples of formalin-fixed paraffin-embedded salivary gland ACC were immunohistochemically evaluated for the presence of ER and PgR. ER was not detected in any of the tumors and PgR was identified in only two cases. Thus, application of hormone therapy to salivary gland ACC is not supported by the results of the present study.

Adult↗
PubMed2001

Expression of p53 tumor suppressor gene in adenoid cystic and mucoepidermoid carcinomas of the salivary glands.

Seventeen adenoid cystic carcinomas (ACCs) and 27 mucoepidermoid carcinomas (MECs) occurring in the salivary glands were analyzed for p53 tumor suppressor gene alteration (exons 5-8) and protein expression. The cell proliferation activity was also examined by Ki-67 immunohistochemistry. The p53 alterations were detected in three samples (17.6%) of ACC and in four samples (14.8%) of MEC, and were only found in carcinomas arising in the minor salivary glands. The occurrence of the p53 gene alteration is less frequent in ACC and MEC than that in other kinds of tumors, and therefore does not seem to play a critical role in the course of the tumorigenesis in ACC and MEC. All ACC samples arising from the minor salivary glands exhibiting p53 gene alterations showed recurrence/metastasis, thus suggesting a poor outcome of these patients. All ACCs and three out of four MECs samples with p53 gene alterations showed the lowest degree of p53 immunostaining ratio, thus suggesting that no correlation exists between the p53 gene alterations and the p53 immunostaining in these salivary gland carcinomas. No significant relationship was demonstrated between the immunostaining ratio of either p53 or Ki-67 and the morphological growth pattern or patient clinical course in the ACC samples. The p53 immunopositivity in MEC correlated to the histological grade. The Ki-67 immunostaining ratio was also significantly related to the histological grade and the clinical course in MEC.

Adult↗
PubMed2002

Establishment and characterization of a human adenoid cystic carcinoma line of the salivary gland which is serially transplantable and spontaneously metastasises to the lung in nude mice.

Adenoid cystic carcinoma (ACC) is a rare malignant tumour of the head and neck occurring in the salivary glands. We established a human ACC line which is serially transplantable in nude mice and designated it as KOA-1. The KOA-1 tumour doubled in 9.3 days and retained the histological characteristics of a solid pattern of ACC even after 22 serial passages. The KOA-1 metastasised to the lung when transplanted subcutaneously into the back. This tumour line may serve as a useful model for exploration of the biological behaviour and treatment of human ACC.

Animals↗
PubMed2002

Immunohistochemical expression of CA19-9 and CA125 in mucoepidermoid and adenoid cystic carcinomas of the salivary gland.

This study examined the immunohistochemical expression of carbohydrate antigens CA19-9 and CA125 and their relationship to various biological parameters in 27 mucoepidermoid carcinomas (MEC) and 18 adenoid cystic carcinomas (ACC) arising from salivary glands. The series showed higher immunopositivity for CA125 (67% for MEC; 33% for ACC) than for CA19-9 (59% for MEC; 11% for ACC). CA19-9 epitope was mainly expressed in cystic (MEC) and cribriform/tubular (ACC) components of carcinoma tissues. Solid components in MEC occasionally showed positive staining for CA19-9. CA125 was evenly expressed in both ACC and MEC tissues regardless of their different histological components. The positive expression of CA19-9 and CA125 in the carcinoma tissues did not influence the clinical course of patients with MEC and ACC. A significant relationship was only demonstrated between the immunohistochemical expression of CA125 and the low proliferative activity (LI) evaluated by Ki-67 immunohistochemistry. However, no significant relationship was found between LI and the patients' clinical course. These results suggest that the immunostaining for CA19-9 and CA125 provide no reliable data to predict the clinical course of patients with MEC and ACC of the salivary glands.

Adult↗
PubMed2002

Polymorphous low-grade adenocarcinoma and adenoid cystic carcinoma: a review and comparison of immunohistochemical markers.

Polymorphous low-grade adenocarcinoma (PLGA) and adenoid cystic carcinoma (ACC) have several overlapping histological patterns, including cribriform, tubular and solid patterns. The overlapping clinicopathological features of PLGA and ACC may result in a diagnostic pitfall. ACC has a much worse prognosis than PLGA, making differentiation important for therapeutic and prognostic purposes. Histopathological features remain the most reliable criteria to distinguish between these two tumours. Although PLGA and ACC have many features in common, PLGA is uncommon in the major salivary glands. Histopathological distinction is therefore mainly a problem in tumours of minor salivary gland origin where small biopsies often contribute to diagnostic difficulties. This paper reviews studies which have utilised several immunohistochemical markers in attempts to distinguish between PLGA and ACC, and also studies which have focussed on the two tumours individually. The potential discriminating value of immunohistochemistry between cases of PLGA and ACC still remains controversial.

Actins↗
PubMed1998

Induction of differentiation in maxillary adenoid cystic carcinomas by adoptive immunotherapy in combination with chemoradiotherapy.

The successful treatment results of a case of maxillary adenoid cystic carcinoma (ACC) and the possibility of differentiation of ACC cells with chemoradioimmunotherapy are described. Combined therapy was applied to two maxillary ACCs. Adoptive immunotherapy consisted of intra-arterial injection of lymphokine-activated killer cells (total 9.0 x 10(8) cells) and recombinant interleukin-2 (1.8 x 10(5) U) and interferon-gamma (1.8 x 10(5) U) was combined with 60Co radiation (50 Gy), 5-fluorouracil (4000 mg) and peplomycin (10 mg). Immunohistochemical staining of the biopsy material obtained during the therapy revealed a marked decrease of proliferating cell nuclear antigen-positive cells and a prominent increase of Lewis Y antigen- and bone morphogenetic protein-2-positive cells. The disappearance of tumour cells and the remodeling of the sinus wall with calcification in the sinus cavity, which had been occupied by the tumour, were observed after therapy in both patients. Adoptive immunotherapy in combination with chemoradiotherapy is useful for the treatment of ACC.

Aged↗
PubMed1976

Mycotic flora in tonsils and adenoids. A microbiological and histological evaluation.

The tonsils of 147 patients with chronic tonsillitis and the adenoids of 134 children with recurrent respiratory infections were cultured for fungal organisms and studied microscopically. A control group consisted of 68 healthy persons. Positive cultures were obtained in 64% of patients with chronic tonsillitis, in 21% of children treated with adenoidectomy, and in 69% of the control group. Candida albicans, Saccharomyces sp. and Aspergillus were the most common organisms. The histological investigations revealed no evidence of pathogenecity in these organisms. They were found in the tonsillar crypts, and no granulomatous inflammation was seen surrounding them.

Adenoids↗
PubMed1977

Clinical and histological malignancy of adenoid cystic carcinoma.

The authors report on 25 cases of adenoid cystic carcinoma of the head and neck region. The tumours were divided into 4 histological malignancy groups. Treatment generally consisted of surgery performed with as large a margin as possible, in combination with split course million volt therapy, about 6,000 rads, usually given preoperatively. It was found that the patients in the groups of lower malignancy generally managed for a comparatively long time without a clinically demonstrable recurrence, while the patients in the groups of higher malignancy relapsed rather quickly and often had metastases. The patients in the groups of higher malignancy also died relatively soon after the histological tumour preparations.

Adult↗
PubMed1986

Adenoid cystic carcinoma presenting as a mass in the neck.

Three of a personal series of 82 patients with adenoid cystic carcinoma presented with a node in the neck. Two of these patients had no discoverable primary tumour. One of the latter died rapidly, and might have had an undisclosed primary tumour in the lung. The other remains well 3 years after radical neck dissection, and it is possible that he had a tumour arising in an aberrant cervical salivary rest.

Aged↗
PubMed1989

Adenoid cystic carcinoma of the salivary glands: clinicopathological survey of 51 patients.

A clinicopathological study of 51 cases of adenoid cystic carcinoma in the head and neck region seen over a period of 20 years is presented. The correlation between various histological features and their impact on the results is attempted. Longterm results with respect to loco-regional recurrences, distant metastases and survival with various modalities of therapy are presented. Although this is a small series, radical surgery in keeping with the aim of avoiding undue mutilation, thus preserving the quality of life, followed by a full course of radiotherapy has been the mainstay of treatment and the results here presented justify this approach.

Adult↗
PubMed1990

Adenoidal hypertrophy as the presenting feature of HIV infection.

A case of symptomatic recurrent adenoidal hypertrophy, as the presenting feature of HIV infection in a haemophiliac child, is reported. The incidence of non-malignant nasopharyngeal lymphoid hyperplasia in HIV infection is examined and the relevance of the histological appearance is discussed in relation to progression of disease.

Adenoids↗
PubMed1992

Histological changes during progression of adenoid cystic carcinoma.

Eight cases of adenoid cystic carcinoma were reviewed to determine whether and how the histological features of the tumour vary with the progress of the disease. The tumours were classified by their histological patterns as tubular, cribriform, trabecular or solid. The relative amount of each pattern seen in routine light microscopic sections was calculated histomorphometrically and compared in the primary tumour and recurrent and/or metastatic lesions in the same case. In the early stage, the tubular pattern predominated. Later, the highest percentage shifted to the cribriform, then to the trabecular and finally, in the late stage, to the solid pattern. There was no reverse direction of histological transformation from the solid to the tubular pattern. These results may help to explain previous reports that the tubular pattern usually represents a favourable prognosis, the solid pattern a poor prognosis and the cribriform pattern an intermediate prognosis.

Adult↗
PubMed1995

Excision of adenoid cystic carcinoma of the cervical trachea via an anterior castellated approach.

Adenoid cystic carcinoma of the cervical trachea is rare and its diagnosis and surgical management challenging. We report a case with an unusual presentation and discuss the diagnosis and management. The preferred surgical management is tracheal resection, however this is often not feasible and many alternative techniques have been used. Here an anterior castellated approach is described, a modification of that more commonly used for benign tracheal strictures. We found it gave excellent access to the posterior tracheal wall which we feel is superior to a straight vertical tracheal incision. It also facilitates a tracheal widening procedure if indicated, and safeguards the recurrent laryngeal nerves which are particularly vulnerable in the cervical part of the trachea.

Carcinoma, Adenoid Cystic↗
PubMed1996

Adenoid cystic carcinoma of the maxilla--the value of histopathology in diagnosing a second primary.

Adenoid cystic carcinoma is the commonest tumour of minor salivary glands. In the case described here a pulmonary mass was found. This was likely to be a distant metastasis, particularly as the primary tumour was of cribriform subtype with perineural invasion and resection was microscopically incomplete. However, surgical excision of the pulmonary mass enabled histopathological studies to be carried out which found it to be an unrelated bronchioloalveolar carcinoma.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1997

Adenoid cystic carcinoma of the sublingual salivary gland in a 16-year-old female--report of a case and review of the literature.

Tumours of the sublingual salivary gland are exceptionally rare. The present case report describes an adenoid cystic carcinoma of the sublingual salivary gland occurring in a 16-year-old girl, in itself an uncommon event. In addition, an interesting feature of the presentation was obstruction of the ipsilateral submandibular gland due to involvement of Wharton's duct.

Adolescent↗