Diagnosis and treatment of malignant lymphomas of parotid gland.

OBJECTIVES: This study aims to report surgical outcomes of primary parotid lymphomas and to discuss the histopathological subtypes, incidence rates, and clinical course. PATIENTS AND METHODS: Between January 2002 and December 2014, eight patients (2 males, 6 females; man age 46.6 years; range 25 to 60 years) who were diagnosed with primary parotid lymphoma and underwent parotidectomy were retrospectively analyzed. Demographic characteristics of the patients, histopathological subtypes, disease stage, and survival rates were recorded. RESULTS: The ratio of the patients diagnosed with lymphoma was 2.82% among all patients, while 18.1% of the malignancies were lymphomas. Fine needle aspiration biopsy was non-diagnostic. CD20-positive low-grade B-cell lymphoma was the most common histopathological subtype in 37.5% of the patients. CONCLUSION: Based on our study results, the fine needle aspiration biopsy is not helpful in the diagnosis of the lymphomas of the parotid gland. Although rarely seen, lymphomas of the parotid gland should be considered in the differential diagnosis.

[Our surgical approach to parotid masses: an analysis of 130 patients]. / Parotis kitlelerine cerrahi yaklasimimiz: 130 olgunun analizi.

OBJECTIVES: This study aims to evaluate the surgical procedures applied, histopathologic results, incidence of the disease, and complications in patients with parotid tumors. PATIENTS AND METHODS: Between January 2002 and December 2010, medical records of 130 patients (63 males, 67 females, mean age 47.2 years; range 15 to 81 years) with parotid masses who were admitted to our clinic and underwent parotidectomy were retrospectively analyzed. Age, sex, surgical procedures applied, histopathological results and complications were recorded. RESULTS: A total of 105 masses (79.5%) were superficial lobe, while 27 (20.5%) were located in the deep lobe. Two patients were operated twice due to bilateral lesion at different time. We found that 15.2% of patients had nonneoplastic lesions, 67.4% had benign tumors and 17.4% had malignant tumors. The most frequent benign tumor was pleomorphic adenoma. Among malignant tumors, mucoepidermoid carcinoma, squamous cell carcinoma and lymphoma were found at same frequency. Superficial parotidectomy was performed on 110 patients, whereas 13 patients underwent total parotidectomy and nine patients underwent total parotidectomy plus neck dissection. Fifteen patients (11.4%) developed facial paralysis during the postoperative period. CONCLUSION: Our study results suggest that the distribution of patient age-sex, tumor location, pathologic diagnosis, and postoperative complication rate is consistent with the literature.

Tbx3 represses PTEN and is over-expressed in head and neck squamous cell carcinoma.

BACKGROUND: Despite advances in diagnostic and treatment strategies, head and neck squamous cell cancer (HNSCC) constitutes one of the worst cancer types in terms of prognosis. PTEN is one of the tumour suppressors whose expression and/or activity have been found to be reduced in HNSCC, with rather low rates of mutations within the PTEN gene (6-8%). We reasoned that low expression levels of PTEN might be due to a transcriptional repression governed by an oncogene. Tbx2 and Tbx3, both of which are transcriptional repressors, have been found to be amplified or over-expressed in various cancer types. Thus, we hypothesize that Tbx3 may be over expressed in HNSCC and may repress PTEN, thus leading to cancer formation and/or progression. METHODS: Using immunohistochemistry and quantitative PCR (qPCR), protein and mRNA levels of PTEN and Tbx3 were identified in samples excised from cancerous and adjacent normal tissues from 33 patients who were diagnosed with HNSCC. In addition, HeLa and HEK cell lines were transfected with a Tbx3 expressing plasmid and endogenous PTEN mRNA and protein levels were determined via qPCR and flow cytometry. Transcription assays were performed to demonstrate effects of Tbx3 on PTEN promoter activity. Mann-Whitney, Spearman's Correlation and Wilcoxon signed-rank tests were used to analyze the data. RESULTS: We demonstrate that in HNSCC samples, Tbx3 mRNA levels are increased with respect to their normal tissue counterparts (p<0.001), whereas PTEN mRNA levels are significantly reduced in cancer tissues. Moreover, Tbx3 protein is also increased in HNSCC tissue sections. Over-expression of Tbx3 in HeLa and HEK cell lines causes reduction in endogenous PTEN mRNA and protein levels. In addition, transcription activity assays reveal that Tbx3 is capable of repressing both the basal and induced promoter activity of PTEN. CONCLUSIONS: We show that Tbx3 is up-regulated in tissue samples of HNSCC patients and that Tbx3 represses PTEN transcription. Thus, our data not only reveals a new mechanism that may be important in cancer formation, but also suggests that Tbx3 can be used as a potential biomarker in cancer.

Bilateral tonsillar and esophageal Kaposi sarcoma in an HIV-negative patient.

Tonsillar involvement in Kaposi sarcoma is extremely rare, as only a few such cases have been reported; all but 1 of these previously reported cases occurred in patients with human immunodeficiency virus (HIV) infection. We describe what to the best of our knowledge is the first reported case of concurrent bilateral tonsillar and esophageal Kaposi sarcoma in an HIV-negative patient. A 68-year-old man presented with sore throat and dysphagia. Clinical examination revealed the presence of bilateral and asymmetrical tonsillar masses, as well as generalized lymphadenopathy in the cervical chain. The masses were resected, and findings on histopathologic analysis were consistent with Kaposi sarcoma. In addition, human herpesvirus 8 was demonstrated on a tonsil specimen by polymerase chain reaction, and microinvasive squamous cell carcinoma was also detected. Later, another Kaposi sarcoma lesion was detected in the lower third of the esophagus. We recommend that clinicians not discount the possibility of oral classic Kaposi sarcoma in the workup of an immunocompetent patient with oral vascular lesions.

Parapharyngeal lipoma: a case report.

A 44-years-old male presented with right infraauricular swelling. It had been four months since he was aware of the mass. He had not felt any pain or tenderness. Computed tomograpy demonstrated a homogenous, regular surfaced mass located in the prestyloid and poststyloid parapharyngeal space. Its density was concordant with lipomatous tissue, so it was considered to be an infiltrating parapharyngeal lipoma. Postoperative diagnosis revealed a similar result. We believe that computed tomograpy is an effective method of diagnosing parapharyngeal space tumors and tansparotid approach for this localization is very useful for both preserving facial nerve functions and exposing the mass clearly. We report a case of parapharyngeal lipoma slightly invading the deep lobe of the parotid gland.

Giant cervical lipoma invading carotid artery: a case report.

Lipomas are one of the most frequently encountered benign tumors in any location. There is limited information about head and neck lipomas in the litetature and most data is in the form of case reports. Lipomas can rarely reach gigantic sizes and can invade surrounding tissues, especially skeletal muscles, and in this case they are called infiltrating lipomas. In this manuscript we report a case of cervical giant lipoma surrounding and infiltrating the common carotid artery which was treated by grafting carotid artery, and our diagnostic work-up and treatment procedure are discussed in the light of the literature.

DNA gains and losses of chromosome in laryngeal squamous cell carcinoma using comparative genomic hybridization.

PURPOSE: A larynx squamous cell carcinoma (LSCC) is one of the most common forms of cancer and may exhibit various complex karyotypes. MATERIALS AND METHODS: We used comparative genomic hybridization (CGH) to analyze DNA gains and losses in 15 squamous cell carcinomas that consisted of 4 glottic, 10 supraglottic, and 1 transglottic localization samples. RESULTS: The majority of the chromosomal alterations detected were gains: 3 samples of LSCCs revealed high level amplification, while 6 samples displayed gains in various chromosomal regions (17p, 3p, 4p, 5p, 6q, 8p, 9p, 14q, 18p and Xq). One sample was found to have losses (chromosomes 15q and 22q) and 5 had normal CGH profiles. CONCLUSION: Many of these gained regions (4p, 5p, 8p, 10q, 18q and Xq) were novel sites, which may harbor oncogene(s) that potentially play an important role in squamous cell tumorigenesis and progression at supraglottic localizations.

[Treatment modalities of nasopharyngeal angiofibroma]. / Nazofarenks anjiyofibromlarinda tedavi yaklasimlari.

Nasopharyngeal angiofibroma is a rare, benign vascular tumor originating from the sphenopalatine foramen. It primarily affects adolescent males. Due to its propensity to locally destructive growth, the tumor may lead to fatal epistaxis, intracranial extension, and life-threatening complications such as intraoperative hemorrhage. Many treatment modalities have been used for the management of nasopharyngeal angiofibroma, but surgery and external beam radiation therapy have proved to be the only effective treatment modalities with acceptable morbidity. While endoscopic surgery provides successful results for early stage tumors, recent technological advances in radiotherapy offer significant advantages in advanced and recurrent tumors.

Phosphorus recovery from digested sewage sludge as MAP by the help of metal ion separation.

This study was designed to solve metal ion influence problem on phosphorus recovery from digested sewage sludge as MAP. The experimental steps were proceeded to maximize MAP production and its quality. Used experimental steps were: All digested sewage sludge samples were taken from Stuttgart University sewage treatment plant for research and education (LFKW). Four different forms of LFKW digested sewage sludge were used as feeding sample. These were: original digested sludge, diluted digested sludge, centrifuged digested sludge and incinerated digested sludge. A Donnan membrane unit having a Nafion 117 (DuPont) cation exchange membrane was used to remove metal ions from the samples used. Highest metal ion removal efficiencies, which were 98%, 97%, and 80% for Al, Ca and Fe ions, respectively, were obtained from incinerated digested sludge run. Incinerated digested sludge run was used as preliminary step for MAP production and high quality MAP was produced. Produced MAP fulfils all requirements related with Düngemittelverordnung 2003 and it could be used as a fertilizer in Germany.

Expression of PTEN protein in patients with laryngeal squamous cell carcinoma.

OBJECTIVE: PTEN (phosphatase and tensin homologue deleted on chromosome 10), also referred to as MMAC1 (mutated in multiple advanced cancers) gene was recently identified as a putative tumor suppressor in a variety of malignant tumors. PTEN expression has been investigated in some squamous cell carcinomas (SCC) of head and neck. However, there is only little knowledge about laryngeal malignancies. Therefore, we examined PTEN product protein immunohistochemically in 30 consecutive laryngeal specimens from patients with laryngeal SCC and compared the results according to the clinicopathologic characteristics of the patients. METHOD: Surgical resection specimens of patients with laryngeal SCC were stained for PTEN protein using a primary rabbit polyclonal anti-PTEN antibody. Standard avidin-biotin immunohistochemical analysis was used to process the sections. The extent and intensity of PTEN staining in the specimens were compared according to the age and sex of the patients and localization, differentiation, size and stage of the tumor. RESULTS: Out of 30 tumoral specimens (23 glottic and 7 supraglottic) 22 showed decreased PTEN staining intensity compared to the adjacent normal tissue. The extent of cytoplasmic PTEN staining was significantly less in supraglottic tumors (p < 0.05). When characteristics of the patients were analyzed according to the extent of cytoplasmic PTEN staining no difference was observed according to age, sex, measure, differentiation, T or N status. CONCLUSION: A significant decrease in the extent of PTEN staining was observed in supraglottic SCC. It could be worthwhile to test if PTEN expression is diminished in patients with more aggressive laryngeal tumors, with special attention to tumor localization in larger series.

Detection of micrometastatic tumor cells in head and neck squamous cell carcinoma. A possible predictor of recurrences?

OBJECTIVE: To evaluate the presence of micrometastatic tumor cells in the peripheral blood samples of the patients with head and neck squamous cell carcinoma (HNSCC) and to determine whether the presence of micrometastatic cells had any biological relevance in terms of local recurrences or metastasis during a follow-up period of 3 years. METHODS: We included 21 consecutive patients with untreated primary HNSCC admitted to the Ear Nose and Throat Department of Akdeniz University Medical School, Antalya, Turkey between February and October 2002. Squamous carcinoma cells in peripheral blood samples of these patients prior to surgery were detected via a magnetic cell separation technique using anti-epithelial cell adhesion molecule antibody, and thereafter evaluated by light microscopy with hematoxylin and eosin staining. RESULTS: Seven out of 21 patients showed squamous carcinoma cells in peripheral blood samples. Patients with stage III and IV tumors were nearly 5 times more likely to show micrometastatic cells compared with those with stage I and II tumors (6/12 versus 1/9). During the follow-up, 2 patients out of 7 with micrometastasis had recurrences. None in the micrometastasis negative group relapsed. CONCLUSION: We suggest that HNSCC patients with detectable tumor cells in peripheral blood represent a subset of patients who should be followed up more closely for possible recurrences.

Immunohistochemical distribution patterns of collagen type II, chondroitin 4-sulfate, laminin and fibronectin in human nasal septal cartilage.

Collagen type II, chondroitin 4-sulfate, laminin and fibronectin are major components of cartilage matrix. It is important to know their distribution patterns to evaluate relationships between cartilage cells and surrounding cartilage matrix. In the present study, we investigated localization patterns of these macromolecules in human nasal septal cartilage by immunohistochemical methods. Samples of human nasal septal cartilage were obtained from patients with nasal septum deviations who underwent septoplastic operation and were prepared for immunohistochemical examination. Distribution patterns of cartilage matrix macromolecules correlated with those found in other cartilage tissues. Diffuse staining of collagen type II was found in the cartilage matrix, chondroitin 4-sulfate immunostaining was present in the cytoplasm and like a pericellular ring around chondrocytes. Laminin immunostaining was found in the cytoplasm of chondrocytes, and fibronectin was localized in the pericellular matrix and in capsules of human nasal septal cartilage. Moreover, fibronectin was also detected at high levels in the interconnecting segments between adjacent chondrons. In conclusion, similar localisation patterns of the components investigated in human septal cartilage as in other tissues indicate that these macromolecules may play a role in both cell-matrix adhesion and matrix-matrix cohesion in the pericellular microenvironment surrounding nasal septal cartilage chondrocytes as in other cartilage tissues.