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PubMed1994

Prognostic value of argyrophilic nucleolar organizer regions (AgNOR) count in adenoid cystic carcinoma of salivary glands.

A retrospective study was performed on 34 patients with adenoid cystic carcinoma (ACC) to see if quantification of argyrophilic nucleolar organizer regions (AgNOR) was correlated with their prognosis. Mean follow-up period was 113 months. According to detailed clinical data that included tumor recurrences, metastases and patient survival conditions, two groups were classified. Group 1 consisted of 20 live patients without metastases, of whom 16 were free of disease, while group 2 comprised 14 patients with metastases among whom 12 died of tumor. The silver staining technique was applied to paraffin embedded specimens. In each case, 300 nuclei were randomly examined and the mean AgNOR per nucleus was calculated. All patients from group 2 had mean AgNOR counts greater than 4, whereas 65% of patients from group 1 had mean AgNOR counts less than 4. In addition, statistical analysis showed that the pooled mean AgNOR count in group 2 was significantly higher than in group 1 (P < 0.01). The present results suggest that silver staining technique promises to be a useful supplementary method for prognostic evaluation of salivary ACC, and may be performed before planning the treatment.

Adult↗
PubMed2004

Prognostic value of apoptosis and apoptosis-associated proteins in salivary gland adenoid cystic carcinoma.

The purpose of the present study was to investigate the level of apoptosis and expressions of p53, mdm2 and bcl-2 proteins in salivary gland adenoid cystic carcinoma (ACC) to determine potential relationships among apoptosis, apoptosis-associated proteins and clinical cumulative survival. Thirty-nine formalin-fixed, paraffin-embedded cases, cribriform (17), tubular (13) and solid (9), were studied by immunohistochemistry. Apoptosis detection and analysis were determined by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL). There was an inverse significance between the apoptotic index (AI) and bcl-2 expression (P = 0.018), whereas no correlation was found between the AI and either p53 or mdm2 expression (P = 0.416 and P = 0.456). Co-expression of p53 and mdm2 was found in 22 cases (P = 0.037). Patients with p53-positive tumors had a worse prognosis than those with p53-negative tumors (P = 0.014). Patients with a high AI had a better cumulative survival than patients with a low AI (P = 0.038). The present study suggests that p53 expression and AI can be useful as prognostic values; bcl-2 protein plays a role in the down-regulation of apoptosis and is also potentially useful as a prognostic parameter in salivary gland ACC.

Apoptosis↗
PubMed2005

Adenoid basal carcinoma of the uterine cervix: report of two cases with reference to adenosquamous carcinoma.

Adenoid basal carcinoma (ABC) of the uterine cervix is a rare neoplasm with excellent prognosis. Differential diagnosis between ABC and an ABC-like lesion of adenosquamous cell carcinoma (ASC) of the cervix is important due to their contrasting prognosis. Reported herein are two cases of ABC that have been compared with seven ASC exhibiting ABC-like lesions from approximately 2600 resected uterine cervical malignancies diagnosed at Shikoku Cancer Center. The two ABC were incidentally found in the uterine cervix of 69-year-old and 59-year-old Japanese women due to cervical intraepithelial neoplasia grade 3 and to squamous cell carcinoma, respectively. The ABC consisted of infiltrating nests of basaloid cells with low nuclear atypia. The patients remained alive without recurrence for 9 years and 18 months, respectively. An ABC-like lesion was defined as basaloid cell nests simulating ABC, but with some features indicating malignant potential. However, the differential diagnosis was sometimes difficult because two of seven ABC-like lesions were originally diagnosed as ABC. Immunohistochemically, cytokeratin 7 was negative for the basaloid cells of two ABC, but positive for six of six ABC-like lesions of ASC, while cytokeratin 8 was positive for both ABC and ASC. This cytokeratin pattern might provide a good tool for distinguishing between ABC and an ABC-like lesion of ASC when the histological findings are equivocal.

Adult↗
PubMed2006

Adenoid cystic carcinoma of the trachea: a long-term problem.

Adenoid cystic carcinoma of the trachea, although rare, is the second most common primary tumour of the trachea. It is a slow-growing tumour found in younger patients than the more common squamous cell carcinoma and is relatively resistant to treatment, but metastasizes late in the course of disease and even in unresectable cases can be palliated successfully for many years. We present a retrospective 20-year series of this condition from a single institute encompassing 13 patients of whom 6 were resected and 7 treated by palliative methods. A review of hospital records was carried out over the period 1984-2003. Details collected included symptoms before diagnosis, length of time from onset of the first symptom to diagnosis, resection details, survival statistics and accessory procedures tried before and after consideration of resection. The overall 5-year survival was 38.5%, but the mean survival in resected patients was 66 months as against 36 months for unresectable patients. Although most patients presented with dyspnoea, this was initially often attributed to other factors. The mean time of diagnosis from the onset of symptoms was 16 months. Although complete resection remains the management of choice if feasible, modern techniques of maintaining the airway in unresectable patients can give useful palliation for years.

Adult↗
PubMed2005

Adenoid cystic carcinoma of maxillary sinus with metastatic hepatocellular carcinoma. Case report.

A case of collision tumor in the left maxillary sinus composed of adenoid cystic carcinoma (ACC) and metastatic hepatocellular carcinoma (HCC) is reported. Radiographic examination revealed masses in the liver and bilateral lung metastases. Histologically, proliferation of tumor cells with resemblance to HCC was observed, in addition to the ACC. For this reason, differential diagnosis between a second primary tumor and metastasis was made. The metastatic lesion immunohistochemically showed positivity for hepatocyte antigen (OCH1E5) and protein induced by vitamin K absence or antagonist II (PIVKA-II), sustaining the HCC diagnosis. Primary ACC and metastatic HCC in the maxillary sinus are rare, and this may therefore be the first case of maxillary sinus tumor with both these elements.

Antigens, Neoplasm↗
PubMed1997

Multiple malignant cylindromas of skin in association with basal cell adenocarcinoma with adenoid cystic features of minor salivary gland.

This unusual case is that of a middle-aged man exhibiting a tumor diathesis including a basal cell adenocarcinoma with features of adenoid cystic carcinoma arising in minor salivary gland of lip in association with multiple primary malignant cylindromas of skin. The labial lesion showed invasive tubules, solid epithelial sheets and cribriform structures. It did not exhibit PAS positive juxta-tubular basement membrane material. The skin lesions all showed features of a highly infiltrative cylindromatous carcinoma with two cell types, peripheral palisading and prominent PAS positive juxta-tubular basement membrane material. Immunocytochemical studies of the lip lesion and one of the skin lesions showed similarities, including positive staining for high and low molecular weight keratins and S-100 with negative staining for CEA. The precious descriptions of tumor diatheses involving dermal cylindromas and dermal analogue tumors of salivary glands and the distinctions with the present study are noted. If benign and even malignant cylindromas were described in the literature to be associated with basal cell adenocarcinoma of the major salivary glands, our case is unique by its association with this rare malignant tumor in a minor salivary gland.

Adenocarcinoma↗
PubMed1986

Adenoid cystic carcinoma of the salivary glands: an immunohistochemical study.

Twenty-four cases of adenoid cystic carcinoma from the Salivary Gland Registry of the University of Hamburg were analysed with respect to their differentiation and subclassification. With immunohistochemical methods, several groups of marker substances were analysed in these tumors: marker for a glandular function; immunoglobulins; metalloproteins; tumor markers; substances associated with the basal membrane and carbohydrate chains. The following patterns of histological differentiation were found: cribriform pattern with typical pseudocysts; tubular pattern with ductal elements; trabecular pattern with predominance of hyalinized stromal elements; basaloid pattern with low differentiated cells. For every pattern, a special immunohistochemical profile could be established. The morphological and immunohistochemical analysis revealed the following relation between the different patterns: Origin of the malignant proliferation is presumably the terminal ductal system of the salivary glands (indifferent cell of the reserve cell type). This cell can differentiate in 2 directions: a myoepithelial and a ductal cell type. Immunohistochemically, the presence of basement membrane-associated substances is accompanied by the appearance of myoepithelial-like cells. The presence of secretory products is a feature of ductal cells.

Antibodies, Neoplasm↗
PubMed1991

Immunohistochemical localization of MAM-3 and MAM-6 antigens in adenoid cystic carcinoma.

MAM-3 and MAM-6 antigens were detected immunohistochemically in 34 cases of adenoid cystic carcinomas (ACC) of the salivary glands and these patterns were compared to these of epithelial membrane antigen (EMA) and laminin. ACC was histologically divided into three types; the cribriform pattern, the tubular and trabecular pattern, and the solid cluster pattern. Immunostaining of EMA and MAM-6 antigen had a similar distributions in the luminal borders of luminal tumor cells, whereas the MAM-3 antigen was slight or negative in luminal borders. Myoepithelial derived tumor cells of ACC accompanying hyaline stroma demonstrated positive staining for the MAM-6 antigen (whole cell positive type), and luminal tumor cells of microcysts showed strong staining for the MAM-3 antigen. Laminin staining was confined to the basement membrane and surface borders in pseudocyst cavities. In salivary gland ACC, laminin staining can be used as a marker of pseudocyst surfaces and immunostaining of EMA and the MAM-6 antigen as a marker of luminal borders of cyst. These two histochemical markers were useful for discriminating pseudocyst and cyst.

Antigens, Neoplasm↗
PubMed1995

Correlation between argyrophilic nucleolar organizer region (AgNOR) counts and histologic grades with respect to biologic behavior of salivary adenoid cystic carcinoma.

The quantification of argyrophilic nucleolar organizer regions (AgNOR) was performed in 34 cases of adenoid cystic carcinoma (ACC) to determine (1) whether AgNOR count correlates with its different histologic grades pertinent to prognosis, and (2) whether AgNOR counts can offer any additional prognostic advantage over histologic grading. According to Szanto et al.'s histologic grading criteria (4), 12 cases were Grade 1, 7 cases Grade 2, and 15 were Grade 3. Patients were divided into 20 favorable cases (without metastases) and 14 unfavorable cases (with metastases). Although most Grade 3 tumors had high AgNOR counts (> or = 4) and Grade 1 tumors with low (< 4) AgNOR counts outnumbered those with high AgNOR counts, considerable overlap of AgNOR values in different grades was observed. However, all unfavorable cases had high AgNOR counts regardless of their histologic grades, suggesting that the metabolic alterations associated with the malignancy level of ACC may partly be portrayed by the AgNOR count, irrespective of the histologic appearance. Cumulative survival rates of Grade 1 tumors and of tumors with low AgNOR counts were better than those of Grade 3 tumors and those with high AgNOR counts. Within the limited number of cases in this series the AgNOR count exhibits a potential for identifying some aggressive ACCs that cannot be detected by histology alone.

Adult↗
PubMed1999

Immunohistochemical detection of DNA topoisomerase type II alpha and Ki-67 in adenoid cystic carcinoma and pleomorphic adenoma of the salivary gland.

Immunohistochemical detection of cell proliferation-associated antigens was investigated in 28 cases of adenoid cystic carcinoma (ACC) and 20 cases of pleomorphic adenoma (PA), using antibodies against DNA topoisomerase type II alpha (topo-II) (Ki-S1) and Ki-67 (MIB-1). The correlation of staining indices with clinicopathological data, histological features and prognosis was also studied. The topo-II value was significantly higher in ACC than in PA (P<0.0001), and highest in the solid growth pattern of ACC. In addition, significant relationships were found between topo-II values and clinical features such as local recurrence, surgical margins, and distant metastases. By log-rank test, the topo-II index was also correlated significantly with patient survival (P<0.01). The values of topo-II index paralleled those of Ki-67 index in ACC, and a correlation coefficient of 0.97 was obtained. Topo-II may be considered an additional marker for estimating the proliferating fraction of cells and for predicting the short-term prognosis for patients with salivary gland tumors.

Adenoma, Pleomorphic↗
PubMed2004

Expression patterns of integrins on pleomorphic adenoma and adenoid cystic carcinoma: study on specimens and in vitro investigation of the effects of extracellular matrix on the expression of these adhesion molecules.

BACKGROUND: Pleomorphic adenoma (PA) and adenoid cystic carcinoma (ACC) are neoplasms of distinct behaviour, showing similar origin, cell components and marked presence of extracellular matrix (ECM). Interactions between cells and ECM are important in the biology of tumours, being partially mediated by integrins. This study investigated these interactions on PA and ACC using paraffin-embedded tissue and an in vitro model of these conditions. METHODS: Expression of integrins in paraffin-embedded samples was assessed by immunohistochemistry. Cells from PA and ACC were characterized using immunofluorescence, and integrin patterns of expression were investigated on cells cultivated on different ECM proteins. RESULTS: Luminal cells of both PA and ACC were more intensely positive for integrins than myoepithelial cells. In vitro studies revealed that PA cells expressed more integrins than ACC cells regardless the ECM protein present. CONCLUSIONS: This study revealed particular patterns of integrin expression in both specimens and in vitro models of PA and ACC. This might prove useful for a better understanding of the biology of these lesions.

Actins↗
PubMed2005

Expression of IgSF in salivary adenoid cystic carcinoma and its relationship with invasion and metastasis.

BACKGROUND: The aim of the present work was to study the potential effect of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and neural cell adhesion molecule (NCAM) of immunoglobulin superfamily on the invasion and metastasis of salivary adenoid cystic carcinoma (SACC). METHOD: The expressions of ICAM-1, VCAM-1 and NCAM of forty cases with SACC were examined by immunohistochemical methods using respective kits. RESULTS: A significant relation showed between the expression level and histological differentiation, expression of ICAM-1 and VCAM-1 in solid SACC was greatly increased compared with NCAM; SACC with metastatic lymph node or local recurrence displayed significant relationship to the up-regulation of ICAM-1 and VCAM-1, and to the down-regulation of NCAM. CONCLUSIONS: It is proposed that ICAM-1 and VCAM-1 may play a role in the invasion and metastasis of SACC. NCAM may be an invasion-resistant adhesion molecule.

Adult↗
PubMed1999

Apoptosis-induced and -suppressed cells in salivary gland adenoid cystic carcinoma: correlation with histological growth patterns.

OBJECTIVE: It is well known that adenoid cystic carcinoma (ACC) arising from salivary glands shows a correlation between prognosis and histological growth patterns. The aim of the study was to evaluate whether three growth patterns of ACC are related to the distributions of apoptosis-induced and -suppressed tumor cells. MATERIALS AND METHODS: We examined 77 cases of ACC including tubular (18 cases), glandular (50) and solid (9) patterns. In order to visualize the apoptotic cells, terminal deoxynucleotidyl transferase (TdT)- mediated dUTP-biotin nick end labeling (TUNEL) and avidin-biotin complex staining using Lewis Y (LeY) antibody were applied to paraffin sections. For detection of the apoptosis-suppressed cells, immunohistochemistry employing bcl-2 antibody was utilized. RESULTS: Apoptosis index (AI) based on the TUNEL-stained specimens were tubular, 7.0; glandular 2.4; solid, 5.1. In tubular type, apoptotic cells were frequently located in the inner tubular layer rather than the outer layer. Solid type had scattered apoptotic cells in the nests. Bcl-2 expression was found in 61% of tubular, 20% of glandular and 22% of solid cases. The localization of bcl-2 protein was noticed in outer tubular cells, and peripheral cells or undifferentiated cells in solid pattern. CONCLUSIONS: The peculiar distribution of apoptotic cells may result from the various proportions and distinctive arrangement of neoplastic ductal cells and neoplastic myoepithelial cells in ACC. Apoptotic cells and bcl-2 positive apoptosis-suppressed cells may participate in the construction of characteristic histological appearances of ACC.

Apoptosis↗
PubMed2005

Bilateral intraosseous adenoid cystic carcinoma of the mandible: report of a case with lung metastases at first clinical presentation.

OBJECTIVE: Malignant epithelial tumours arising in the jaws are very rare. Adenoid cystic carcinoma (ACC) represents approximately 7.5% of all carcinomas and only a few cases of intraosseous (central) ACC have been reported in the literature. MATERIALS: The salient clinico-pathological features of a case of ACC, bilaterally occurring in the mandible of a young caucasian woman who also had lung metastases are reported to appropriately characterize such unusual lesions and discriminate them from other tumours that more commonly affect the mandible. RESULTS: The patient presented with a painful swelling of the right retro-molar area and paraesthesia of the ipsilateral lower lip and radiological investigations disclosed bilateral radiolucent lesions of the mandible with unequivocal signs of malignancy but without intra-lesional calcifications or association with teeth roots or cystic component. Conventional histological examination disclosed typical ACC with solid and cribriform growth patterns and extensive infiltration of the adjacent tissues. CONCLUSIONS: The diagnosis of intraosseous malignant salivary gland type neoplasms is very difficult in view of their rarity and lack of specific signs and mainly achieved after histological examination and complete clinico-radiological work up. As surgical treatment of the patient was not indicated, due to extensive neoplastic disease, the patient is being controlled with multimodal treatment, including chemo- and radiotherapy and is alive with persistent disease 3 years after the original diagnosis.

Adult↗
PubMed2005

Adenoid cystic carcinoma and polymorphous low-grade adenocarcinoma of minor salivary glands: a comparative immunohistochemical study using the epithelial membrane and carcinoembryonic antibodies.

OBJECTIVE: The purpose of this study was to investigate immunohistochemically the expression of epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA) in adenoid cystic carcinoma (AdCC) and polymorphous low-grade adenocarcinoma (PLGA) in an attempt to assess the ability of these markers to distinguish AdCC from PLGA when the histological features on routine hematoxylin and eosin are equivocal. MATERIALS AND METHODS: Fourteen specimens of AdCC, 10 PLGA, and five normal minor salivary glands fixed in 10% formalin and embedded in paraffin, were retrieved from the files of our department and were retrospectively studied with the streptavidin-biotin complex method using the epithelial membrane and carcinoembryonic antibodies. RESULTS: The immunoreactivities and the expression patterns of EMA and CEA in AdCC and PLGA were similar. CONCLUSIONS: The results of this study suggest that the immunostaining of AdCC and PLGA with EMA and CEA could not offer an adjunctive aid in differential diagnosis between these two tumors.

Adenocarcinoma↗
PubMed1984

Mycoplasma pneumoniae--stimulation of lymphocytes obtained from adenoid vegetations and blood in children with and without serological evidence of Mycoplasma pneumoniae infection.

Thymidine incorporation in lymphocytes obtained from adenoids (AVL) and blood (PBL) and stimulated in vitro with Mycoplasma (M.) pneumoniae antigen, was determined in 16 children with serological indication of a current or recent M.pneumoniae infection, and in 14 controls. Both AVL and PBL gave higher responses in the M.pneumoniae-positive group than in the control group. The best discrimination between the two groups was achieved by AVL stimulated by M.pneumoniae, AVL did not respond, indicating that in this assay recent or actual M.pneumoniae infection is better expressed by AVL than by PBL.

Adenoids↗