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Cyclooxygenase-2 expression in an adenoid cystic carcinoma of the uterine cervix.

Adenoid cystic carcinoma (ACC) of the uterine cervix is extremely rare, frequently metastasizes to distant organs, and its prognosis is poorer than squamous cell carcinoma of the uterine cervix. The reasons for its poor prognosis are unclear. This case had both an ACC and a carcinoma in situ (CIS) of the uterine cervix, so the expressions of CD34, vascular endothelial growth factor (VEGF) and cyclooxygenase-2 (COX-2) were investigated in both tumors. Hysterectomy was performed on a 76-year old woman and the uterine cervical tissues immunohistochemically analyzed. Expressions of CD34 were positive in the ACC lesions but negative in the CIS ones and angiogenesis was confirmed in ACCs. Furthermore, expressions of VEGF and COX-2 were shown in ACC, but were absent in CIS. In conclusion, the expression of COX-2 in ACC may induce the expression of VEGF, increase angiogenesis and enhance tumor growth and invasion.

Aged↗

[Study on the effects of adenoid-tonsillar operation in infants under 2 years of age].

Infants with upper airway obstruction caused by adenotonsillar hypertrophy often suffer from sudden death. We have performed adenotonsillar operations on patients under 2 years of age. These infants had sleep apnea, dyspnea, poor increase of body weight or cardiac hypertrophy. This is a report on a clinical study on these infants. Between October 1988 and February 1998 eighteen patients under 2 years of age (17 boys and one girl) had an adenotonsillar operation in our hospital. Three had adenotomy and two had adenotomy and one-sided tonsillectomy. The remaining thirteen patients had adenotonsillectomy. During the post operative period, all showed remarkable improvement in sleep apnea and dyspnea with the exception of four patients in whom reoperation was required because sleep apnea was brought on again by adenoid rehypertrophy and tonsillar hypertrophy. Based on this study, we conclude that adenotonsillectomy is effective in infants with sleep apnea or dyspnea caused by adenotonsillar hypertrophy.

Adenoidectomy↗

[The role of stromal components and Ca++ ATPase in pleomorphic adenoma and adenoid cystic carcinoma].

In order to clarify the neoplastic-mesenchymal cell interaction, tumor structures were histologically classified into duct, solid and scattered types, and stromal changes were observed in each type with histochemical techniques. The quantitative and qualitative differences of the stromal components as proteoglycan and collagen were histochemically differed in these morphological features. Ca++ ATPase was ultrastructurally localized on the plasma membrane of myoepithelial cell in salivary glands. The activity of Ca++ ATPase changes in tumor cell differentiation of pleomorphic adenoma and adenoid cystic carcinoma. These results suggest that the stromal components and Ca++ ATPase play an important role on the tumor cell proliferation and differentiation in these tumors.

Adenoma, Pleomorphic↗

[Adenoid cystic carcinoma of the head and neck: a clinical review of 29 cases].

Pathological data and the outcomes of 29 patients with adenoid cystic carcinoma of the head and neck treated between 1975 and 1990 were reviewed. Patients consisted of 21 females and 8 males, with a median age of 59 years. The overall 5-year and 10-year survival rates determined by Kaplan-Meier analysis were 84.2% and 52.9%, respectively. Patients in whom pathological data indicated a frequent solid pattern of carcinoma had high incidences of metastasis and poor prognoses. The effectiveness of local control was found to have no relation to the pathological data of the tumor, but rather depended upon whether anatomical limitations restricted complete resection of the tumor. All 7 patients who had cervical lymph node metastasis underwent neck dissection, which was useful in controlling metastatic spread. Distant metastases were present in 6 patients, and the lung was the most frequent site of metastasis.

Adult↗

[Cystic adenoid carcinoma of the prostate. Report of two cases].

OBJECTIVE: We report two cases with the pathologic diagnosis of cystic adenoid carcinoma of the prostate, an extremely rare tumor. METHODS: We evaluate two patients with different age, clinical presentation, diagnosis, treatment and outcome. RESULTS: The ages were 41 and 59, the symptoms perineal pain and lower urinary tract symptoms, on digital rectal examination a round hard tumor mass and normal exam, respectively. PSA and prostatic acid phosphatase were normal; Transrectal ultrasound may be normal or find a hypoechoic node. The first patient underwent radical prostatectomy and adjuvant immunotherapy; six years after surgery he developed lung metastasis and died. The second patient underwent radical cystoprostatectomy with orthotopic urinary diversion with good outcome after two years of follow-up. CONCLUSIONS: The clinical presentation is non specific, with the diagnosis generally obtained by transurethral resection or transrectal biopsy after the suspicion of an abnormal digital rectal examination or ultrasound. The tumor is immunoreactive to p53 and citokeratins 7 and 34 Beta E12, and the treatment of choice is radical cystoprostatectomy because it is a potentially aggressive neoplasia; adjuvant treatment may be added.

Adult↗

[Expressions of oncogene products in adenoid cystic carcinomas of salivary glands: immunohistochemical study].

In 43 cases of adenoid cystic carcinomas of the salivary glands (ACC), expressions of the oncogene products such as epidermal growth factor receptor (EGF-R), erbB-2 product, c-myc product and N-myc product were investigated immunohistochemically. First, we confirmed the specificity of the antibodies used with the 13 cell lines. Of the anti-EGF-R antibodies, clone 29. 1. 1 reacted only with A431 but not with the other cell lines overexpressing EGF-R, so that it was most likely to cross-react with the blood type A antigen. Also, the anti-N-myc product antibody revealed the presence of a certain cross-reacting antigen in Lu65. Overexpression of EGF-R was observed in only one case. Nine cases (20.9%) showing tubular and cribriform patterns overexpressed the erbB-2 product, but the signals were mainly localized in the cytoplasm as a granular appearance. Eighteen cases (41.9%) with slight cellular atypia showed an overexpression of the c-myc product. The immunolocalization of the c-myc product was at the nuclei in most cases, or both the nuclei and the cytoplasm in some cases. None of the ACC expressed the N-myc product. It is speculated that the multiple oncogene expressions might be partly related to the acquirement of the differentiated or malignant phenotype in the ACC.

Adult↗

Adenoid cystic carcinoma of the ovary.

We describe a case of ovarian adenoid cystic carcinoma (ACC) of the left ovary in a 23-year-old woman. The tumor had the typical cribriform pattern of ACC, lacked any component of surface epithelial carcinoma, and showed myoepithelial differentiation. The features of salivary gland-type tumor seen in this case are unusual and different from those of so-called ACC-like carcinomas of the ovary, which only resemble the salivary gland tumor histologically.

Adult↗

[Adenoid cystic carcinoma of the larynx. Case report and literature review].

Adenoid cystic carcinoma is a rare neoplasm that comprise approximately 0.25% of all laryngeal malignancies. The rarity of these lesions has prohibited clarification of definitive therapy. Traditionally, radical surgery is performed because of the usually high stage at presentation. A case of larynx ACC is reported. The literature on this topic has been reviewed, in order to describe the natural course and the different treatments of this tumor.

Biopsy↗

[Adenoid cystic carcinoma of respiratory airways: course and treatment].

Until recently, adenoid cystic carcinoma (ACC) has been considered to be a borderline disease between benign and malignant because of its low level of malignancy, slow growth and scarce aggressivity. ACC is now a histologically well defined tumor and is currently classified as malignant; it has a prolonged natural history, is infiltrative, and tends to recur locally and give rise to local-regional metastases or, more rarely, remote metastases. Its incidence in the lower airways is low (0.1% of all broncho-pulmonary neoplasms). Eight patients (6 women and 2 men) have undergone surgery for ACC since 1969. The initial clinical picture included long-term evolution and symptoms were usually produced by large caliber obstruction of the airways, mainly affecting the trachea and large bronchi. Three cases involved the trachea resection with end-to-end anastomosis in two cases, right pneumonectomy in two others (one of which also involved tracheal carina resection), and two lobectomies. After thoracotomy, resection of the tumor was deemed impossible in two cases. Postoperative mortality was 12% (1 patient). Complementary radiotherapy was provided in the two non-resectable cases, or when there was invasion of resected edges or regional metastasis involving ganglia. Total survival was 71.4% after two years, 57.1% after five years and 38% after ten years, after excluding postoperative exitus. When the trachea was involved, survival was 33.3% after two and five years and nil after ten years, with the longest survival 108 months. When bronchi were involved, survival was 75% at five and ten years. We conclude that ACC is a rare, locally invasive tumor that tends to local recurrence, but that survival after surgery is prolonged with or without adjuvant radiotherapy.

Adult↗

Cytological diagnosis of adenoid cystic carcinoma breast--a case report.

The cytologic features of a case of adenoid cystic carcinoma of breast diagnosed on fine needle aspiration cytology (FNAC) in a 52 years old female are described. FNAC was carried out on outer quadrant of breast. The characteristic cytological features were numerous single to branching small round to Avoid cells at places forming microacini. Numerous pink hyaline globules of variable sizes were seen along with finger like projections containing basement membrane material.

Biopsy, Needle↗

Reduced expression of p27(Kip1) protein in relation to salivary adenoid cystic carcinoma metastasis.

BACKGROUND: Adenoid cystic carcinoma (ACC) is a malignant tumor of salivary gland origin. It tends to grow slowly but shows frequent recurrence and metastasis, ultimately with a poor outcome. Reduced expression of a cyclin-dependent kinase inhibitor, p27(Kip1), has been reported to correlate with poor survival for patients with various types of carcinoma. However, there has been no previous study reported of p27(Kip1) expression in ACC, to the authors' knowledge. METHODS: To evaluate p27(Kip1) as a prognostic marker, the authors examined the immunohistochemical expression of p27(Kip1) protein in 29 ACCs and correlated its expression with clinicopathologic findings. Eleven pleomorphic adenomas (PAs) were also examined to compare the p27(Kip1) expression in benign and malignant salivary gland tumors. RESULTS: All PAs expressed p27(Kip1) at high levels, whereas 83% of ACCs (24 of 29) showed reduced expression of this protein. Furthermore, the expression levels were significantly lower in ACCs with metastasis than in those without metastasis. The authors also examined the expression of p27(Kip1) in 2 ACC cell lines (ACCh and ACC3) by Northern and Western blot analysis to elucidate the possible mechanism of p27(Kip1) reduction in ACC. Both ACCh and ACC3 expressed p27(Kip1) mRNA, but ACCh did not produce p27(Kip1) protein. In ACCh, the expression of p27(Kip1) protein was induced by treatment with a proteasome inhibitor. CONCLUSIONS: Overall, these findings suggest that reduced expression of p27(Kip1) may correlate with the development and progression of salivary ACC and can be an indicator of its malignant behavior. They also suggest that increased proteasome-mediated degradation may play an important role in this reduction of p27(Kip1) expression.

Adenoma, Pleomorphic↗

KIT protein expression and analysis of c-kit gene mutation in adenoid cystic carcinoma.

The c-kit proto-oncogene encodes a transmembrane receptor tyrosine kinase (KIT), which is expressed in several normal human tissues, especially mast cells and interstitial cells of Cajal. Expression of KIT has been noted in several types of neoplasms and gene mutation has been shown as a mechanism of c-kit oncogene activation in some tumors. Recently, a single adnexal adenoid cystic carcinoma (ACC) was reported to demonstrate KIT expression, however, examination of KIT expression or c-kit mutation in ACC of salivary glands has not been performed. We examined archival tissue samples from 30 ACC of major and minor salivary glands for KIT protein expression by immunohistochemistry with a polyclonal antibody and c-kit gene mutation by polymerase chain reaction amplification and DNA sequencing. KIT protein expression was noted in 90% of ACCs. An association between the presence of at least 50% KIT positive neoplastic cells and Grade 3 ACC or a solid growth pattern was observed (P < .05). KIT expression in normal or nonneoplastic salivary gland tissue was absent. No c-kit juxtamembrane domain (exon 11) or phosphotransferase domain (exon 17) mutations were found in any of the tumors examined. In conclusion, KIT protein expression is correlated with tumor grade of salivary ACC. However, gene mutation of exon 11 or exon 17 is not a mechanism of c-kit activation in these neoplasms.

Adult↗

Selection of quantitative criteria for evaluating metastases of a highly metastatic salivary adenoid cystic carcinoma cell line to the lungs of nude mice.

OBJECTIVE: To select reliable quantitative criteria for evaluating metastases of a highly metastatic salivary adenoid cystic carcinoma cell line (ACC-M) cell to the lungs of nude mice. MATERIALS AND METHODS: The within-group coefficients of correlation of 5 parameters were measured from lung slides using a video image digital analysis system (VIDAS), and the intergroup coefficients of correlation of 6 sets of parameters from all the lungs, which were taken from ACC-M lung metastases models, were calculated and statistically analyzed. RESULTS: The within-group coefficients of correlation of 5 parameters are as follows: ratio of area of metastases, t = 0.9 (P < 0.001); area of metastases, t = 0.7 (P < 0.05), size of lung section, numbers of metastases, and size of the largest metastatic focus all t < 0.4 (P > 0.05). The intergroup coefficients of correlation of the parameters are as follows: ratio of area of metastases was assigned 1, weight of the lung was 0.9755, and area of metastases was 0.8628. CONCLUSION: For evaluating lung metastases of ACC-M, the ratio of area of metastases and weight of the lung are precise; the area of metastases is also significant within the 6 quantitative parameters.

Animals↗

Adenoid cystic carcinoma of trachea.

Adenoid cystic carcinoma of trachea is a rare but distinct salivary gland-type malignant neoplasm. This paper described such a case in a young female in whom the mass that progressed to cause almost complete obstruction before it was diagnosed.

Adult↗

[nm23 expression and its correlation with lung metastasis in human salivary adenoid cystic carcinoma].

The nm23 gene products, nucleoside diphosphate kinase (NDPK), expression in salivary adenoid cystic carcinoma (ACC) was evaluted by using LSAB immunohistochemical method. Of 25 cases tested, 16 (64.0%) showed positive staining, in which, higher incidence of positive staining was found in ACC without lung metastasis (88.2%, 15/17) than in that with lung metastasis (12.5%, 1/8; P < 0.01). Expression of NDPK/nm23 was correlated with the P-TNM pattern (P < 0.05), otherwise it was not correlated with pathologic types (P > 0.05). The result suggest that the nm23/NDPK may play a role in suppressing the metastatic potential in ACC.

Carcinoma, Adenoid Cystic↗

[Changes in tracheal and lung sounds before and after resection of adenoid cystic carcinoma of the trachea].

A 79-year-old woman was admitted to our hospital with complaints of wheezing and dyspnea. Adenoid cystic carcinoma was diagnosed from the findings on biopsy specimens obtained by fiberoptic bronchoscopy. The tumor was resected and end-to-end anastomosis was performed. Precision analyses of lung sounds were conducted before and after the operation. During eupnea the tracheal sounds prior to operation contained an accentuated, high-frequency component at about 1,500 Hz. The tracheal sounds included a single monophonic wheeze during deep inspiration and 5 wheezes during forced expiration. By contrast, lung sounds in the chest wall were almost normal both before and after the operation. We concluded that increases in high-frequency components in tracheal sounds and the manifestation of various wheezes can be useful in diagnosing tracheal stenosis and/or tumors.

Aged↗

Immunohistochemical study of basaloid squamous cell carcinoma, adenoid cystic and mucoepidermoid carcinoma in the upper aerodigestive tract.

Non-squamous cell carcinoma is a rare but distinct neoplasm of the upper aerodigestive tract. Among these carcinomas, basaloid-squamous cell carcinoma (BSCC) has frequently been confused with adenoid cystic carcinoma (ACC) and mucoepidermoid carcinoma of the upper aerodigestive tract. In this study, we examined immunohistochemically the expression of differentiation-related substances, including cytokeratin (CK) subtypes, p53 and p27, and cell adhesion-related molecules E-cadherin and alpha-catenin to clarify the biological features of these neoplasms. We studied seven cases of BSCC of the oesophagus, five cases of ACC and seven cases of mucoepidermoid carcinoma. Squamous cell carcinoma and adenocarcinoma of the oesophagus and trachea were also studied for comparison. Among the cytokeratin subtypes examined, CK14, CK17 and CK19 immunoreactivity was detected in BSCC. ACC and mucoepidermoid carcinoma were immunopositive for CK8, CK14 and CK17 and for CK8, CK14, CK17 and CK19, respectively. These findings suggest that CK subtypes, especially CK8, CK14 and CK17, are useful in differentiating these malignancies. BSCC was more frequently associated with decreased E-cadherin and alpha-catenin immunoreactivity than ACC and mucoepidermoid carcinoma. Nuclear p53 immunoreactivity was detected more frequently in BSCC (5 out of 7) than in ACC (2 out of 5) and mucoepidermoid carcinoma (4 out of 7). There were no significant differences in p27 immunoreactivity among these carcinomas. Carcinoembryonic antigen (CEA) immunoreactivity was detected in mucoepidermoid carcinoma (2 out of 7), SCC (8 out of 11) and adenocarcinoma (9 out of 9), but it was not detected in BSCC (7) or ACC (5). Carbohydrate antigen 19-9 (CA19-9) immunoreactivity was detected only in mucoepidermoid carcinoma (4 out of 7) and adenocarcinoma, but not in BSCC, ACC, or SCC. These findings indicate that BSCC, ACC and mucoepidermoid carcinoma are distinct neoplasms arising in the upper aerodigestive tract. In addition, decreased expression of E-cadherin and alpha-catenin proteins and increased p53 expression in BSCC may be correlated with aggressive behaviour.

Adenocarcinoma↗