Radioprotective Effects of Amifostine, L-Carnitine and Vitamin E in Preventing Early Salivary Gland Injury due to Radioactive Iodine Treatment.

OBJECTIVE: Standard treatment of differentiated thyroid cancer includes total thyroidectomy and high-dose Radioactive Iodine Therapy (RIT) for ablation of remnant thyroid tissue. When administered systemically, RIT can cause radiation-induced damage in non-targeted normal tissues. The aim of the present study was to compare the protective effects of amifostine (AMI), LCarnitine (LC), and Vitamin E (EVIT) against high dose radioactive iodine treatment induced Salivary Gland (SG) damage using SG scintigraphy and histopathological examination. METHODS: Forty adult guinea pigs were studied. Twenty guinea pigs receive 555-660 MBq 131Iodine intraperitoneally (IP) to ablate the thyroid and impair the parenchymal function of the SGs. The animals were divided into eight groups as follows: (1) Group 1 (control): 1 mL IP PS (physiological saline); (2) Group 2: single dose of 200 mg/kg IP AMI one hour prior to 1 mL IP PS; (3) Group 3: 200 mg/kg IP LC and 1 mL IP PS for 10 days; (4) Group 4: 40 mg/kg intramuscular (IM) EVITand 1 mL IP PS for 10 days; (5) Group 5: IP RIT after premedication; (6) Group 6: Single dose of 200 mg/kg IP AMI one hour prior to RIT and IP RIT after premedication; (7) Group 7: IP RIT after premedication and 200 mg/kg IP LC for 10 days starting one day before RIT; and (8) Group 8: IP RIT after premedication and 40 mg/kg IM EVIT for 10 days starting one day before RIT. Scintigraphy was performed 1 month after treatment. SGs were examined by light microscopy and a histopathological scoring system was used to assess the degree of SG damage. RESULTS: There were significant differences in the body weight and thyroid hormone levels between the groups after treatment. CONCLUSION: The individual use of AMI, LC and EVIT for radioprotection yield different levels of protection against radioactive iodine treatment injury in SGs; however, none of the agents could provide absolute protection at the doses administered in this experimental model.

Sclerotic effect of oxytetracycline on the submandibular gland: An experimental model.

Oxytetracycline has been suggested as an alternate therapy for chronic recurrent sialadenitis and sialorrhea. We conducted an experimental study to investigate the sclerotic effect of this drug on the submandibular gland by histopathologic methods. Our subjects were 20 New Zealand white rabbits, which were divided into two groups of 10. The right submandibular gland of the rabbits in the active-treatment group was injected with 0.3 ml of oxytetracycline (100 mg/ml), and that of the controls was injected with saline. Four weeks after the injections, all the glands were removed. Histopathologic studies, including hematoxylin and eosin and Masson trichrome staining, were carried out. The glands were evaluated for tissue inflammation, congestion, fibrosis, edema, lipomatosis, and atrophy. To investigate apoptosis, terminal deoxynucleotidyl transferase-mediated dUTP-digoxigenin nick-end labeling (TUNEL) immunohistochemical staining was used. In the study group, inflammation (n = 9), congestion (n = 9), fibrosis (n = 6), edema (n = 6), and lipomatosis (n = 4) were observed; in the sham group, only lipomatosis was seen (n = 5). The TUNEL assay results for acinar cells were 4.51 ± 1.41% in the oxytetracycline group and 2.08 ± 1.76% in the control group (p = 0.006); the corresponding figures for the duct cells were 7.05 ± 0.87% and 3.10 ± 2.26% (p = 0.001). Based on our findings, we conclude that oxytetracycline might be a viable alternative for the treatment of chronic recurrent sialadenitis and sialorrhea. However, more research in this area is needed.

Clinical significance of Ki-67, c-erbB-2 and E-cadherin expressions in open partial laryngectomy patients.

OBJECTIVES: This study aims to analyze the correlation between biomarkers and risks of cervical lymph node invasion, recurrence, distant metastasis and survival regarding the clinicopathological variables in laryngeal cancers. PATIENTS AND METHODS: Forty-one patients with laryngeal cancers were examined retrospectively. The correlations evaluated between E-cadherin, Ki-67, c-erbB-2 expressions, tumor site, differentiation, the risk of cervical lymph node metastasis, perineural, perivascular, pericapsular invasion and recurrence as well as survival time. RESULTS: There was significant correlation between T-grade and the survival rates, and between pericapsular invasion and the lowest survival rates. There was no significant correlation between E-cadherin, Ki-67, c-erbB-2 expressions and clinicopathological variables of tumor. Positive correlation between strong stain of E-cadherin and Ki-67 proliferation index was determined. CONCLUSION: These markers are not reliable prognostic and predictive factors for laryngeal cancers. E-cadherin expression was protected in well-differentiated and less invasive cancers, which maintain their cell-cell adhesions whereas it was reduced in undifferentiated cancers. Positive correlation between E-cadherin and Ki-67 proliferation shows that histopathological differentiation of laryngeal cancers is maintained in spite of the high proliferation index.

Less aggressive disease in patients with primary squamous cell carcinomas of the thyroid gland and coexisting lymphocytic thyroiditis.

AIM OF THE STUDY: Primary squamous cell carcinoma (SCC) of the thyroid gland is extremely rare. Infrequently, primary SCC of the thyroid gland is accompanied by other thyroid diseases such as Hashimoto's thyroiditis (HT). Recently, studies have demonstrated that differentiated thyroid cancer with coexisting HT has a better prognosis. However, the prognosis of patients with primary SCC of the thyroid gland and coexistent HT has not been clearly identified. We compared the clinical characteristics and disease stages of patients with primary SCC with and without lymphocytic thyroiditis (LT). MATERIAL AND METHODS: We reviewed reports of primary SCC of the thyroid gland published in the English literature. RESULTS AND CONCLUSIONS: We identified 46 papers that included 17 cases of primary SCC of the thyroid gland with LT and 77 cases of primary SCC of the thyroid gland without LT. Lymph node metastasis and local invasion rates did not differ between these two groups. Distant metastases were absent in patients with LT, and were observed in 13 (16.9%) patients without LT. A greater proportion of patients without LT had advanced stage disease (stage IV A-B-C) than patients with LT (p < 0.05). Patients with primary SCC of the thyroid gland and coexisting LT had lower tumour-node-metastasis stage and frequency of distant metastasis than those without LT. Lymphocytic infiltration in patients with SCC appears to limit tumour growth and distant metastases.

Diagnostic efficacy and importance of fine-needle aspiration cytology of thyroid nodules.

BACKGROUND: Fine-needle aspiration cytology (FNAC) in the diagnosis of thyroid nodules is an easy and cost-effective method. The increase in malignancy rates of the excised nodules due to the high sensitivity and specificity rates of the FNAC is remarkable. AIM: The aim of this study was to assess the effectiveness of FNAC in the evaluation of thyroid nodules by comparing the results with histopathologic evaluation and comparing the consistency of the results with the literature. MATERIALS AND METHODS: In this study, 1607 FNACs of 1333 patients which were classified according to the Bethesda system and 126 histopathological evaluations obtained from this group were evaluated. The mean age of the patients was 51.24 (range: 17-89, 17% male and 83% female). The sensitivity, specificity, positive and negative predictive values, and accuracy rates were evaluated. RESULTS: The sensitivity was 87.1% and specificity was 64.6%. The positive and negative predictive value and accuracy rates were 76.1%, 79.5%, and 77.3%, respectively. CONCLUSIONS: In our study, the evaluation of thyroid FNAC samples with Bethesda system highly correlated with the results of histopathological diagnosis. However, combination of additional and advanced diagnostic methods such as immunocytochemical studies and molecular pathology techniques enhance the prognostic value of FNAC in patients with atypia of undetermined significance or follicular lesion of undetermined significance, lesions suspicious for malignancy, and suspected follicular neoplasm.

Schwannoma in the anterior orbita.

A schwannoma is a rare benign tumour of peripheral nerve origin. We present a case of a 65-year-old woman with a 1-year history of a slowly enlarging, painless and movable mass, palpable by fingers in her right lower eyelid, adjacent to the inferior orbital rim. No apparent mass was present by macroscopic examination. A subciliary incision and blunt dissection through the septum revealed a pearl-like round and encapsulated cystic mass between the fat pads just below the septum. A total excision of the tumour was performed. Histopathology and immunohistochemistry led to the diagnosis of schwannoma. Although rare, schwannoma should be considered in the differential diagnosis of well-capsulated masses in the periorbital region.

Sclerotic effect of bleomycin on the submandibular gland: an experimental model.

OBJECTIVES: To evaluate the sclerotic effect of bleomycin on the submandibular gland histopathologically and assess it as a possible alternative therapy for sialorrhea. METHODS: An experimental model was designed and 18 New Zealand white rabbits were used. The rabbits were divided into two groups: a bleomycin group (n=9) and a sham group (n=9). The submandibular glands of the bleomycin group were injected with 0.3 ml bleomycin (3mg/ml) while the sham group received 0.3 ml saline. Four weeks after the procedure, the glands were removed. Histopathological studies including hematoxylin-eosin and Masson's trichrome stain were carried out. The glands were evaluated for tissue inflammation, fibrosis, edema, lipomatosis, atrophy and congestion. To investigate apoptosis, terminal deoxynucleotidyl transferase (TdT)-mediated digoxigenin-11-dUTP nick-end labeling (TUNEL) immunohistochemical staining was used. RESULTS: In the group injected with bleomycin, inflammation (n=8), edema (n=4), fibrosis (n=3), congestion (n=4) and lipomatosis (n=7) were observed. In the sham group, only lipomatosis was observed. The TUNEL assay results were 5.06 ± 1.18 (p<0.05) for acinar cells and 8.46 ± 0.82 (p<0.05) for ductal cells in the bleomycin group. This was significantly different from the results in the sham group. CONCLUSIONS: Apoptosis, inflammation, fibrosis, edema, lipomatosis and congestion were observed in the ductal and acinar cells of the bleomycin group. Bleomycin may be an alternative treatment for sialorrhea cases. However, more research is needed.

Syncronized Warthin's tumor in bilateral parotid gland and nasopharynx.

Warthin's tumor is a benign salivary gland tumor of the parotid gland. Although bilateral or multicentric involvement of the parotid gland is common, extraparotid involvement is seen rarely. The nasopharynx is an unusual region for extraparotid involvement. In this article, we present a 52-year-old male case with a synchronized Warthin's tumor in the bilateral parotid gland and nasopharynx, and we discuss the clinical management of the disease.

A rare presentation of a bronchogenic cyst: presternal, subcutaneous and 42-year-old man.

Bronchogenic cysts are generally detected shortly after birth or in early childhood. Most lesions are found in the mediastinum, along the tracheobronchial tree or in the lung parenchyma. Cutaneous or subcutaneous bronchogenic cysts are rarely reported. Our patient was the second case in the English literature who had a cyst over the manubrium sterni in adult life. Surgical total excision is the definitive treatment of extrathoracic bronchogenic cysts, needle aspiration management should not be tried because of association with malignant lesions as mucoepidermoid carcinoma and malign melanoma have been reported to arise from them.