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PubMed1985

Adenoid cystic and adenoid basal carcinomas of the cervix.

Adenoid basal and adenoid cystic carcinomas of the cervix are uncommon and differ from each other in their histology, treatment, and prognosis. Whereas adenoid basal carcinoma is a slow-growing, locally invasive lesion amenable to simply hysterectomy, adenoid cystic carcinoma is an aggressive tumor associated with regional lymph node involvement and late pulmonary metastases. This study, based on the evaluation of nine cases of adenoid cystic and five cases of adenoid basal carcinoma of the cervix, reviews the literature and formulates a program for the management of these rare lesions.

Adult↗
PubMed1979

Radiographic evaluation of adenoidal size in children: adenoidal-nasopharyngeal ratio.

Adenoidal-nasopharyngeal ratios (AN ratios) obtained by simple linear measurements from lateral skull radiographs are described. The AN ratio reliably expresses adenoidal size and patency of the nasopharyngeal airway. The validity of the ratio as an indicator of adenoidal size was determined by evaluation of measurements of radiographs of 1,398 infants and children and comparison with a subjective visual assessment made by experienced observers in 92 patients. An AN ratio greater than 0.80 was present in 34 of 36 patients (94%) subjectively judged to have enlarged adenoids.

Adenoids↗
PubMed1988

Basal cell hyperplasia, adenoid basal cell tumor, and adenoid cystic carcinoma of the prostate gland: an immunohistochemical study.

Basal cell hyperplasia (BCH) is an uncommon proliferative lesion of the prostate gland. We studied ten cases of BCH, one case of an unusual adenoid basal cell tumor (ABT), and one case of a prostatic adenoid cystic carcinoma (ACC), using a panel of antibodies to define the histogenesis of these lesions. Monoclonal antibodies (MoAb) directed against a cytokeratin, which selectively stains basal cells (34 beta E12), and against muscle-specific actin, which stains myoepithelial cells (HHF35), were used. In addition, antibodies directed against prostatic acid phosphatase (PAP), prostate-specific antigen (PSA), S-100 protein, and vimentin were used. In the normal prostate, epithelial cells reacted positively with 34 beta E12, PAP, and PSA, and negatively with the actin, S-100 protein, and vimentin antibodies. In BCH, positive staining was seen for 34 beta E12, PSA, and PAP, with no reactivity for actin, S-100 protein, and vimentin. In ABT and ACC, positive reactivity was demonstrated for all antibodies except actin and vimentin. These findings indicate that the basaloid cells of BCH, ABT, and ACC are derived from basal cells of the normal prostate gland and suggest a continuum among the three lesions. The presence of S-100 protein in ABT and ACC may be related to the lack of this antigen's specificity for myoepithelial cells. The absence of reactivity with the HHF35 MoAb supports our belief that the S-100 positivity does not necessarily indicate myoepithelial cell differentiation.

Acid Phosphatase↗
PubMed1988

"Adenoid cystic" carcinoma and adenoid basal carcinoma of the uterine cervix. A study of 28 cases.

Adenoid cystic carcinoma (ACC) and adenoid basal carcinoma (ABC) of the uterine cervix are rare tumors that have often been regarded as a single entity. We studied 28 cases of these neoplasms, with 14 cases in each category. Most patients were over 60 years of age, and there was a high proportion of black women. The majority of the women with ACC presented with postmenopausal bleeding and had an obvious mass on pelvic examination. Despite the tumors' architectural similarity to ACC of the salivary gland, microscopic examination of the cervical carcinomas showed necrosis, a high mitotic rate, and greater nuclear pleomorphism. In all but one of the cases, the tumor cells were negative for S-100 protein on immunoperoxidase staining--a finding that provides evidence against a myoepithelial component. However, S-100-positive dendritic cells were present in the stroma of the tumors and among the neoplastic cells. The patients with ABC were usually asymptomatic, without a gross abnormality of the cervix. Microscopic examination disclosed small nests of basaloid cells, almost always beneath, and often arising from, in situ or small invasive squamous cell carcinomas. In contrast to ABC, ACC was often complicated by local recurrence or distant metastasis. We conclude that ACC of the uterine cervix differs from ACC of salivary gland origin and is also distinct clinically and pathologically from cervical ABC.

Aged↗
PubMed1992

Anatomic correlates of normal and diseased adenoids in children.

In order to better understand the pathogenesis and sequelae of obstructive adenoid hyperplasia in children, the anatomic relationships of the adenoids to the hard and soft palates, oropharynx, and nasopharynx were studied in vivo in 94 children. Direct, intraoperative palatal, nasopharyngeal, and oropharyngeal measurements were performed in 19 children with normal, nondiseased adenoids (controls [C]) and compared to 75 children undergoing adenoidectomy for obstructive adenoid hyperplasia (OAH) (n = 44) or chronic adenoid infection (CAI) (n = 31). As expected, the weight and volume of the adenoids removed were significantly greater in the OAH vs. CAI group (P < .001). Before adenoidectomy, the volume of the nasopharynx was significantly smaller in the OAH group; however, nasopharyngeal volumes after adenoidectomy were quite similar in all three groups and ranged from 5.4 to 6.2 cc. Only the change in the volume of the nasopharynx after adenoidectomy for obstruction was significant (2.5 +/- 1.2 cc, P < .01). Differences in oropharyngeal and palatal dimensions were not associated with longstanding obstruction from adenoid hyperplasia. These data indicate that the nasal obstruction from adenoid hyperplasia is due to an absolute increase in adenoid size rather than a relatively smaller nasopharynx. Differences in palatal and oropharyngeal dimensions usually described and attributed to longstanding nasal obstruction could not be demonstrated in this study.

Adenoidectomy↗
PubMed1992

Distribution characteristics of immunoglobulin-secreting cells in adenoids. Relationship to age and disease.

Forty-four adenoids and 52 palatine tonsils from 71 children and adolescents (age 3-21 years) undergoing surgery because of adenoidal hypertrophy or recurrent tonsillitis were examined for the presence of immunoglobulin-secreting cells (ISC) employing an enzyme-linked immunospot assay (ELISPOT). ISC constituted less than 2% of the mononuclear cell population. Adenoids contained IgG, IgA, and IgM ISC in significantly lower numbers than palatine tonsils. The predominant isotype of the ISC was IgG, in adenoids accounting for 62% of the ISC and in palatine tonsils for 73%. The relative numbers for IgA and IgM ISC were similar. A significant correlation existed between autologous adenoids and palatine tonsils for the numbers of IgA and IgM ISC, but not for the numbers of IgG cells. These observations suggest that, adenoid and palatine tonsils display similar immunoglobulin distribution patterns within a single individual. However, individuals with hypertrophied adenoids exhibited a numeric decrease in IgG ISC with increasing age (P less than 0.01). Both lymphoid tissues may be involved in mucosal immune defense.

Adenoids↗
PubMedDate not supplied

Adenoids and otitis media with effusion: nasopharyngeal flora.

In order to clarify the role of the microflora of the nasopharynx and adenoids as causative factors of otitis media with effusion (OME), bacteriologic species in middle ear effusions (MEEs), nasopharyngeal smears, and adenoid tissues of children with OME were cultured. The change in the microflora of the nasopharynx after adenoidectomy, and the degree of bacterial agreement between the microflora of the nasopharynx and adenoid tissue were investigated. Nasopharyngeal bacterial flora were investigated in 259 children with OME from November 1984 to November 1987. The patients were divided into two groups: group A (43 patients) underwent adenoidectomy, and group B (216 patients) had no adenoidectomy. Hemophilus influenzae, Streptococcus pneumoniae, Branhamella catarrhalis, and Staphylococcus aureus were cultured in 66.7% of nasopharyngeal smears from group B, and in 46.5% from group A. Adenoid specimens for bacteriologic investigation were obtained from 38 adenoidectomy patients at surgery. Of these, H influenzae were cultured from adenoid specimens taken from 16 of the 26 patients with OME (group C), while only three of the 12 adenoidectomy patients without OME (group D) were found to have H influenzae in their adenoid specimens. The findings of this study suggest that adenoid vegetation plays an important role in the etiology of OME.

Adenoidectomy↗
PubMed1976

Growth of the nasopharynx and adenoid development from one to eighteeen years.

1. The dimensions of the nasopharynx, the adenoids and the nasopharyngeal airway were analyzed in twelve subjects selected from the longitudinal growth study of the Child Research Council of Denver. 2. The nasopharyngeal area was defined by four skeletally defined lines which formed a trapezoid. The nasopharyngeal area was divided into an adenoid-pharyngeal wall and airway areas which were measured using a polar planimeter. The trapezoid analysis proved to be a useful technique for quantification of nasopharyngeal dimensions. 3. The growth of the nasopharynx from nine months to 18 years was established and reflected the different growth patterns of males and females. 4. The sphenoid line/palatal line angle (theta) and nasopharyngeal depth were established early in life and contributed little to the increase of nasopharyngeal area. The increase in nasopharyngeal area corresponded to the descent of the palate from the sphenoid bone which increased nasopharyngeal height. 5. Restriction of the nasopharyngeal airway frequently occurred during the pre- and early school years due to adenoid hypertrophy which exceeded the usual increase in nasopharyngeal capacity. 6. The nasopharyngeal airway increased during pre- and early adolescence due to the concurrent increase in nasopharyngeal area and adenoid involution. 7. Ten subjects had a history of tonsil and adenoid surgery, but of these only five demonstrated what appeared to be complete removal of nasopharyngeal and adenoid tissue as seen on postsurgical radiographs. The possibility that surgical technique may be the critical factor in the completeness of adenoid removal is presented. 8. The mandibular angle did not apear to be affected by periods of nasopharnygeal airway obstruction is any of the subjects in this study. However, an expanded longitudinal study would be required to determine if restriction of the nasopharyngeal airway influences facial form and occlusion.

Adenoids↗
PubMed1989

Characterisation of adenoid cystic carcinoma of the breast by immunohistology.

An adenoid cystic carcinoma of the breast in a 78 year old woman was analysed immunohistologically for the production of type IV collagen, the expression of vimentin, epithelial membrane antigen (EMA) and steroid receptors, and the proliferative activity of the tumour cells. The data were compared with those obtained in eight adenoid cystic carcinomas of salivary glands and in ductal carcinomas of the breast with a cribriform growth pattern. The patients' ages were as follows: 45-80 years (mean 63.2) for the salivary gland carcinomas; 37-69 years (mean 50.6) for the ductal breast carcinomas. In contrast to the cribriform spaces of ductal carcinomas, the pseudocysts in adenoid cystic carcinomas were lined by type IV collagen. The opposite pattern was observed for EMA. Like the myoepithelium of normal breast, the myoepithelium-like cells of adenoid cystic carcinoma stained positive for vimentin while the ductular epithelium-like ones did not. All adenoid cystic carcinomas, including that of the breast, were negative for the oestrogen and progesterone receptors, unlike the ductal carcinomas. Proliferative activity of the adenoid cystic carcinoma of the breast was relatively low. These data broaden the range of antibodies suitable for differential diagnosis of both tumour types. They may explain the differences in prognosis, and they explain why hormonal treatment or radiotherapy of adenoid cystic carcinoma of the breast are often ineffectual.

Antigens, Neoplasm↗
PubMed1992

Differential bacteriology in adenoid disease.

In order to define the differential bacteriology in adenoid disease, adenoids were obtained from 10 children with adenoid hypertrophy and 29 children with chronic adenoiditis. The patients' ages ranged from 18 months to 13 years. After removal of the adenoids, the surface organisms were destroyed by alcohol and flame disinfection. One gram of tissue was sampled for aerobic and anaerobic culture. There was an average of 4.8 isolates per specimen, with 4.2 aerobes and 0.6 anaerobes. The most common isolates were: Haemophilus influenzae (84%), diphtheroids (66%), non-pathogenic Neisseria species (66%), alpha-hemolytic streptococci (64%) and non-hemolytic streptococci (59%). Anaerobes were present in 56% of all cases. The distribution of organisms was similar, regardless of clinical diagnosis. Only eight (21%) of the 39 cases had 'significant' (> or = 10(5) organisms/gm) colony counts. Our study detected no difference in either organism distribution or in total colony counts in chronic adenoiditis vs. adenoid hypertrophy.

Adenoids↗
PubMed1991

[Allergic origin of recurrent middle ear effusion and adenoids in young children].

Recurrent middle ear effusions and adenoids in children might be caused by mechanical obstruction, infection or allergy. From 1989 to 1990 we examined 35 infants with no history of allergic rhinitis but with recurrent adenoids and middle ear effusions. During operation a skin test was performed for common allergens. Afterwards we tried to identify these allergens by RAST tests on tissue homogenates from the removed adenoids, the middle ear effusion and serum samples. Additionally the IgE levels were determined and the adenoid tissue was examined for eosinophils. In 12 of our 35 children (34%) the skin tests showed an allergy, mostly to different kinds of pollen or house dust. From these positive patients the respective allergens could be determined by RAST tests in serum in 84%, in tissue homogenates from the adenoids in 41% and in the middle ear effusions in 50% of cases. 50% of the children with positive skin tests showed an eosinophilia in the adenoid tissue. We did not find any allergen in the RAST of the infants with negative skin tests. The data show a correlation of allergen specific IgE antibodies in the serum of our patients and in the middle ear and the nasopharynx. Together with an eosinophilia these results suggest an allergic genesis of recurrent middle ear effusions and adenoids in about 20% to 30% of our cases. Early diagnostic procedures to rule out allergy in children with appropriate clinical symptoms are useful, and in positive cases antiallergic treatment is recommended.

Adenoids↗
PubMed1992

Pseudovascular adenoid squamous cell carcinoma of the skin. A neoplasm that may be mistaken for angiosarcoma.

The adenoid variant of squamous cell carcinoma has been well-documented in several anatomic sites, including the skin. This tumor is characterized by acantholytic arrays of neoplastic keratinocytes that form pseudoglandular profiles. Although it is typically confused with adenocarcinomas, adenoid squamous cell carcinoma also may be mistaken for malignant vascular proliferations. This report concerns six acantholytic cutaneous squamous cell carcinomas that closely simulated angiosarcomas on conventional histologic examination. They arose in sun-exposed skin areas in middle-aged or elderly patients (mean age, 60 years), five of whom were men. In contrast to the typical clinical appearance of angiosarcoma, pseudovascular adenoid squamous cell carcinoma presented itself as a discrete cutaneous ulcer or crusted tanpink nodule. Microscopically, this lesion was characterized by interanastomosing cordlike arrays of polygonal or flattened tumor cells, with internal pseudolumina that contained detached tumor cells. A connection between the dermal neoplasm and the epidermis was apparent in three cases, but it was focal. Erythrocytes were seen in pseudovascular spaces in five tumors. Immunohistochemically, all examples of pseudovascular adenoid squamous carcinoma were reactive with antibodies to cytokeratin and epithelial membrane antigen (EMA). In addition, three expressed vimentin, two exhibited blood group antigen-positivity, and two bound Ulex europaeus I agglutinin. None of them was immunoreactive for Factor VIII-related antigen, and two of three studied for CD34-reactivity were likewise negative. A control group of six cutaneous angiosarcomas was uniformly nonreactive for cytokeratin and EMA, but they showed positivity for vimentin, Ulex binding, and CD34 positivity in all instances. Pseudovascular adenoid squamous cell carcinoma may be distinguished effectively from angiosarcoma of the skin by attention to its clinical features and by appropriate immunohistochemical studies. These two tumors differ in biologic behavior; three patients with pseudovascular adenoid squamous cell carcinoma died of their tumors, whereas all angiosarcomas in this series proved fatal.

Adenocarcinoma↗
PubMed1990

Enlarged adenoid and adenoidectomy in adults: endoscopic approach and histopathological study.

Adenoid enlargement is uncommon in adults and because examination of the nasopharynx by indirect posterior rhinoscopy is inadequate, many cases of enlarged adenoid in adults are misdiagnosed and accordingly maltreated. This study was conducted on 35 cases of enlarged adenoid aged between 20 and 42 years. The nasal endoscope was utilized to identify the adenoid mass. Adenoidectomy under transnasal endoscopic control was performed and all the excised material was sent for histopathological examination. Adenoidectomy resulted in marked improvement in 94 per cent of cases without major complications. Histopathological examination revealed non-specific inflammatory reaction in 15 cases (43 per cent), pure reactive changes, predominantly follicular hyperplasia, in two cases (6 per cent) and mixed pattern in 18 cases (51 per cent). Endoscopic follow-up for an average 17 months identified recurrence in only two patients. It was concluded that enlarged adenoid tissue in adults has some histopathological differences from that in children and adenoidectomy under transnasal endoscopic control is safe and reliable.

Adenoidectomy↗
PubMed1992

Adenoids: comparison of radiological assessment methods with clinical and endoscopic findings.

Methods of evaluating adenoidal size pre-operatively are controversial. Symptoms and clinical evaluation have been both advocated and condemned. Depending on the methodology, measurement of the radiological adenoidal shadow has been difficult to correlate with the clinical patency of the nasopharyngeal airway and to the actual size of the removed adenoid. Four different methods were used to measure the adenoidal size on 74 radiographs. The methods were evaluated against the degree to which the adenoids obstructed the nasopharynx on flexible endoscopy of the postnasal space. Obstructive symptomatology was also evaluated against the degree of obstruction. The radiological method that best correlated to the endoscopic findings was that of Cohen and Konak (1985). However, obstructive symptomatology had the overall highest correlation to endoscopic findings.

Adenoids↗
PubMed1990

Lymphoid and non-lymphoid cells in the adenoid of children with otitis media with effusion: a comparative study.

We characterized on immuno- and enzymecytochemical level the lymphoid and non-lymphoid cells in the adenoid of children with upper respiratory tract infections (URI) and otitis media with effusion (OME) and compared these with the adenoid of children with URI without OME and with the adenoid of 'healthy' children and adults. Besides macrophages and dendritic cells we also showed the presence of MHC class II positive, ciliated, epithelial cells. These non-lymphoid cells were present in all adenoids. However, their number was less than 1% of all cells. We found no difference in lymphocyte subsets from children with URI + OME compared with those from children with URI alone. These two groups showed a significant decrease of CD8-positive (suppressor/cytotoxic) cells and a slight increase in CD22-positive B cells in comparison to 'healthy' children. No difference was found in percentages of CD4-positive (helper/inducer) cells. The localization of the lymphoid subsets in adenoids of children with URI and/or OME did not differ from those of 'healthy' children and adults.

Adenoids↗
PubMed1991

Mast cells and histamine in adenoid tissue and middle ear.

Biopsy specimens from middle ear mucosa of patients with secretory (SOM) and chronic (COM) otitis media as well as specimens of adenoid and tonsil tissue were studied for mast cells. Effusion fluid, nasopharyngeal secretion and supernatant of crushed adenoid tissue were analyzed for histamine with a radioenzymatic method. Astra blue (AB) safranine stained highly significantly more mast cells than did toluidine blue. Mast cell counts in SOM and COM were similar. There were significantly more mast cells in adenoid subepithelial tissue than in middle ear mucosal subepithelial layer. For epithelium the counts were within the same range in adenoids and middle ear mucosa. Histamine concentrations were significantly higher than plasma levels for SOM fluid and nasopharyngeal secretion. Crushed adenoid tissue showed values over 100 times higher than the histamine level in the secretion.

Adenoids↗
PubMed1977

Characterization of human adenoid cells using surface and functional markers for lymphocyte subpopulations.

Adenoid lymphocytes from children undergoing adenoidectomy were compared with blood cells from the same children using techniques for identifying T cells and B cells. A high proportion of adenoid lymphocytes were immunoglobulin positive cells. Of these only a minor fraction carried receptors for the Fc part of IgG. Adenoid B lymphocytes respond poorly if at all to polyclonal B-cell activators, such as LPS or PPD, which show a different reactivity compared to human splenic cells. The response to anti B2-microglobulin was also different; blood cells responded better than adenoid cells. Thus distinct subpopulations of B lymphocytes reside in different lymphoid organs. The adenoid lymphocyte reactivity might reflect their function in the defence mechanism against infections.

Adenoids↗