Label-free determination of lipid composition and secondary protein structure of human salivary noncancerous and cancerous tissues by Raman microspectroscopy.

The applications of optical spectroscopic methods in cancer detection open new possibilities in oncological diagnostics. Raman spectroscopy and Raman imaging represent noninvasive, label-free, and rapidly developing tools in cancer diagnosis. In the study described in this paper Raman microspectroscopy has been employed to examine noncancerous and cancerous human salivary gland tissues of the same patient. The most significant differences between noncancerous and cancerous tissues were found in regions typical for the vibrations of lipids and proteins. The detailed analysis of secondary structures of proteins contained in the cancerous and the noncancerous tissues is also presented.

Difficulties associated with the diagnosis of mycosis of the oral cavity and throat in chronic lymphocytic leukemia (CLL).

Cases of fungal infections are being encountered more often in clinical practice. The factors associated with a high risk of mycoses include, among others, corticosteroidotherapy, the administration antibiotics with wide spectrum of antibacterial properties, neutropenia, neoplasms. Fungi may play a role in cancer formation, may act as a complication in the course of treatment, and may mimic a neoplastic process by giving a similar clinical picture. In the case of fungal throat infection, patients complain of increased body temperature, a general feeling of weakness, malaise, headache, spontaneous pain intensifying during swallowing, a feeling of an obstacle in the throat or a cough. A physical examination may reveal congestion of the mucosa followed by a unilateral crater ulceration often covered with fat, as well as a thick coating, which is accompanied by foetor ex ore. The submandibular and neck lymph nodes are often greatly enlarged and painful. These symptoms may resemble those associated with the neoplastic process and changes in the course of systemic diseases (agranulocytosis). A correct diagnosis in these cases is necessary for adequate therapy. Chronic lymphocytic leukemia (CLL) is the most common type of leukemia among adults in Europe and North America. It is estimated that in Poland, CLL affects approximately 1,400 people per year. In this paper, a case of 62-years old patient with CLL with fungal infection of oral cavity and throat is presented.

[Castleman disease--a case report]. / Choroba Castlemana--opis przypadku.

The Castleman disease was described for the first time in 1956 by Castleman. It is a rare disease of the lymphatic tissue, manifesting in excessive proliferation of lymphocites B and plasmatic cells in lymph nodes. The etiopathogenesis if the disease still is unknown. The paper presents a case of the Castlemana disease (hyaline vascular type) in 20-year-old man with unilateral enlargement of neck lymph nodes. The case exemplifies the difficulties met in diagnostics and treatment of the Castleman disease.

[Use of tissue autofluorescence in the diagnostics and assessment of treatment efficacy of the head end neck cancer]. / Autofluorescencja tkankowa w diagnostyce i ocenie skutecznosci leczenia nowotworów glowy i szyi.

There are still serious diagnostic and therapeutic challenges in case of carcinoma of the larynx, pharynx and oral cavity most often in patients after radiotherapy. An appropriate choice of a site to take a specimen for histopathology is crucial with regard to establish a diagnosis and find an origin of primary lesion and local recurrence. In this regard our attention is focused on those diagnostic methods which enable to detect even small pathologic lesions. Among them is tissue autofluorescence (DAFE). Its advantages are non-invasiveness, high sensitivity and repeatability. The aim of the study was to validate DAFE as a method for early diagnosis and monitoring of treatment efficacy of head and neck cancers. Forty seven patients were included. Each patient had a fibroscopic investigation with the use of white light and light inducing the tissue fluorescence. A specimen for the histopathology was taken from each site which showed fluorescence in order to verify the diagnosis. The presence of neoplastic lesions was always confirmed with histopathology in parallel with the assessment of the lesion area with fluorescence. DAFE is a non-invasive and useful method for the detection of early cancer lesions with the potential to assess the advances of the disease and to monitor its progress.

[Diagnostic problems in a case of the pyriform sinus carcinoma in a man]. / Trudnosci diagnostyczne w przypadku raka zachylka gruszkowatego u mezczyzny.

Despite a use of many diagnostic tools to assess the stage of the carcinoma of hypopharynx and larynx various problems can still arise. A 45 years old man was admitted with an initial diagnosis of carcinoma of the hypopharynx with metastases to neck lymphnodes (Tin situ N1). Computed tomography of the neck revealed pathologic remodeling of the thyroid cartilage. An oncologist decided to commence a chemotherapy. After 4 cycles of chemotherapy a second CT scan revealed a suspected neoplastic infiltration of the cricoid and thyroid cartilages. After that the patients was disqualified from both radio- and chemotherapy. The consulting laryngologist did not find any pathologies in the larynx and hypopharynx. On palpation there were no enlarged neck lymph nodes. The second specimen taken from the right pyriform sinus was a loosen fragment of the epithelium with the Ca male differentiatum G3. The positron emission tomography imaging found a suspected site 11 mm in diameter situated in front of the carotid vessels. The neoplastic infiltration of the larynx was not confirmed. The patient started the radiotherapy. We are of the opinion that in the presented case the erroneous interpretation of the CT scan was a likely consequence of the improper setting of a window of brightness and contrast. Strong artifacts are also observed in 3D imaging. Another cause of the diagnostic problems could stem form an unfinished calcification of the cartilages which produced an image of irregular areas of calcification and rarely diagnosed T in situ in a pyriform sinus.

[Isolated sarcoidosis of the neck--a report of two cases]. / Izolowana sarkoidoza szyi--opis dwóch przypadków.

Although the first description of sarcoidosis comes from 1877, its etiology still has not been determined. Its frequency in Europe is estimated at 10-80 new cases per 100 thousand people. Sarcoidosis is a granulomatous disease, manifesting mostly in enlargement of lymph nodes of a pulmonary hilus, in changes in pulmonary parenchyma and skin, eyeball, spleen and liver. Changes in about 30% cases also occur in lymph nodes of other regions (neck or retroperitoneal lymph nodes). Changes in salivary glands and heart have also been reported. Isolated sarcoidosis of peripheral lymph nodes occurs rarely. The paper presents two cases of the isolated sarcoidosis of neck lymph nodes. One of them relates to a 70-year-old woman, in which a lymph node sarcoidosis preceded by several months the occurrence of a typical systemic sarcoidosis engaging pulmonary hiluses. The other case is a 30-year-old man, in which the isolated sarcoidosis of lymph nodes was originally diagnosed as a tumor of a submandibular salivary gland. The difficulties in diagnostics of the isolated neck sarcoidosis is discussed as well as its atypical course in both described cases.

[Ameloblastoma of the maxillary sinus--a case report]. / Szkliwiak zatoki szczekowej--opis przypadku.

Ameloblastoma (adamantinoma) is a benign neoplasm deriving from the enamel organ. Its etiology has not been ultimately determined. It constitutes about 1% of all head and neck tumours, and about 11% of teeth-originating tumours. Usually it occurs in the mandible near premolar and molar teeth, more rarely in its anterior part. About 20% of described cases of ameloblastoma relate to the jaw, its very rare location is gingiva or cheak tunica mucosa. The essay presents a case of ameloblastoma of a maxillary sinus in a 65-year-old man. The diagnostic and treatment algorithm in ameloblastoma is discussed.