Immunomorphological assessment of regional lymph nodes for predicting metastases in oral squamous cell carcinoma.

Background: Oral squamous cell carcinoma is the most common neoplasm and comprises of approximately 80% of the cancers occurring in the oral cavity. The role of the host response to this neoplasm has been recognized, and for many years the regional lymph node in tumor-bearing hosts has been considered as an anatomic barrier to the systematic dissemination of tumor cells. Morphological evaluation of the regional nodes has aided in understanding the immune response. Aim: The current study was carried out to observe the morphological changes occurring in the regional lymph nodes and to evaluate whether these features could be helpful in assessing the immunological status of the patient, and thereby, the prognosis of the patient. Materials and Methods: The study was based on lymph nodes from 63 patients with oral squamous cell carcinoma, who underwent radical neck dissection or modified neck dissection. In the lymph node, four morphological patterns were observed that included lymphocyte predominance, germinal center predominance, mixed pattern (sinus Histiocytosis), and an unstimulated pattern. The cases were then divided into four groups according to the predominant immunoreactivity pattern based on the World Health Organization (WHO) standardized system for reporting human lymph node morphology. Results: Revealed that risk of metastases to cervical lymph nodes in patients with lymphocyte predominance was less (28.6%) when compared to the high risk of metastases with germinal center predominance (68%), and these results were statistically significant (P < 0.05). Patients with a mixed pattern showed less risk of metastases (45.4%), while those with an unstimulated pattern had increased risk of metastases (66.6%), but the results were not statistically significant. It was also found that in the positive nodes, germinal center hyperplasia (50.2%) was the predominant pattern. Conclusion: The present study revealed that patients with lymphocyte predominance had less risk of metastases and patients with germinal center predominance had a high risk of metastases to the lymph node.

Treatment of 62 cases of mixed pattern Budd-Chiari syndrome using superior mesenteric vein-caval-right atrium Y shape shunt with artificial vascular graft / 中华肝胆外科杂志

Objective To explore the application value of superior mesenteric vein-caval-right atrium Y shape shunt (abbr.SMV-CV-RA Y shape shunt) as a new approach for treatment of mixed pattern Budd-Chiari syndrome (B-CS).Methods The clinical data of 101 cases of mixed pattern B-CS patients were evaluated for the curative effect.Of the 101 patients,62 were treated with superior ruesenteric vein-caval-right atrium Y shape shunt,26 with splenic vein-caval shunt and 13 with superior mesenteric vein-caval shunt using artificial vascular graft.Results Compared with the plastocyte count of patients receiving splenic vein-caval shunt and superior mesenteric vein-caval shunt,the plastocyte count of 62 cases undergoing SMV-CV-RA shunt increased obviously after operation (P＜0.05).The portal vein pressure of patients with SMV-CV-RA shunt decreased significantly (P＜0.05),but the pressure of patients in splenic vein-caval shunt group and superior mesenteric vein-caval shunt group deceased slightly (P＞0.05).The incidence of hepatic encephalopathy in one year after operation was not significantly different among the 3 groups (P＞0.05).The incidence was 3.2%(2/62),0% (0/26),0% (0/13),respectively.The recanalization rate of artificial vascular graft was 95.2%(59/62),69.2%(18/25),38.4%(5/13),respectively in SMV-CV-RA shunt group,splenic vein-caval shunt group and superior mesenteric vein-caval shunt group.The recanalization rate of artificial vascular graft in SMV-CV-RA shunt group was increased significantly (P＜0.05).Conclusion Compared with splenic vein-caval shunt and superior mesenteric vein-caval shunt,the SMV-CV-RA Y shape shunt can get satisfactory effeet in curing massive hemorrhage of gastrointestinal tract for cutting down the pressure of portal vein and inferior vena.Otherwise,the shunt could eliminate hypersplenia of patients.The splenic vein-caval shunt and superior mesenteric vein-caval shunt are not effective in curing the mixed pattern B-CS.

A Case of Sebaceous Carcinoma

Sebaceous carcinoma of meibomian gland is not so common as is generally re ported. In general feature of this tumor may masquerade as a chronic blepharoconjunctivitis or a chalazion for many months before the true diagnosis is esta blished. In the case of orbital involvement secondarily the patient may occasion ally develop as solid nodule in the fossa of the lacrimal gland that may simulate a primary gland tumor, The authors experienced one case of sebaceous carcinoma which developed in the orbital area. This was a 23-rear-old female who had a growing large mass in the left orbital area, which caused proptosis and decreased vision. Computed tomography of the left orbit demonstrated a large soft tissue mass lesion, about 3 X 3 X 1.5 cm in size, in superotemporal side of the retroorbital portion. The patient underwent a lateral orbitotomy and excisional biopsy of the tumor. Microscopic examination showed intracytoplasmic lipoid vacuoles and mixed pattern which was an admixture of lobular and comedocarcinoma-like area. About 2 months later the tumor recurred, so subtotal orbital exenteration with preservation of lid, conjunctiva, cornea and sclera was undertaken and radiotherapy was taken. However, this tumor was extended to brain.

A Case of Sebaceous Carcinoma

Sebaceous carcinoma of meibomian gland is not so common as is generally re ported. In general feature of this tumor may masquerade as a chronic blepharoconjunctivitis or a chalazion for many months before the true diagnosis is esta blished. In the case of orbital involvement secondarily the patient may occasion ally develop as solid nodule in the fossa of the lacrimal gland that may simulate a primary gland tumor, The authors experienced one case of sebaceous carcinoma which developed in the orbital area. This was a 23-rear-old female who had a growing large mass in the left orbital area, which caused proptosis and decreased vision. Computed tomography of the left orbit demonstrated a large soft tissue mass lesion, about 3 X 3 X 1.5 cm in size, in superotemporal side of the retroorbital portion. The patient underwent a lateral orbitotomy and excisional biopsy of the tumor. Microscopic examination showed intracytoplasmic lipoid vacuoles and mixed pattern which was an admixture of lobular and comedocarcinoma-like area. About 2 months later the tumor recurred, so subtotal orbital exenteration with preservation of lid, conjunctiva, cornea and sclera was undertaken and radiotherapy was taken. However, this tumor was extended to brain.