Helper and cytotoxic T-cell subsets (Th1, Th2, Tc1, and Tc2) in benign and malignant salivary gland tumors.

OBJECTIVE: The objective of this study was to explore the prevalence of T helper type 1 (Th1; CD4(+) IFN-γ (+) ) and Th2 (CD4(+) IL-4(+) ) cells, as well as cytotoxic T cell type 1 (Tc1; CD8(+) IFN-γ(+) ) and Tc2 cells (CD8(+) IL-4(+) ) in peripheral blood of the patients with salivary gland tumors (SGTs). SUBJECTS AND METHODS: Thirty new patients with SGTs and 15 healthy controls were recruited. After intracellular cytokine staining, data acquisition and analysis were performed by flow cytometry. RESULTS: The mean percentages of Th1 and Tc1 cells, as well as the ratios of Th1/Th2 and Tc1/Tc2, were observed to be significantly lower in patients with malignant SGTs in comparison with controls. Furthermore, the geometric mean fluorescent intensity (geometric MFI, representing the cytokine expression intensity) for IL-4 production by Th2 and Tc2 lymphocytes was significantly higher in patients with malignant tumors than controls. Positive correlations were observed between the mean percentage of Tc2 cells with Th2 cells, and with the tumor size in patients with benign and malignant tumors, respectively. CONCLUSION: The findings suggest that the imbalance of Th1/Th2 and Tc1/Tc2 ratios, as well as the increase in the expression of IL-4 by Th2 and Tc2 lymphocytes, may contribute to the pathogenesis of SGTs, especially in malignant cases.

Fine needle aspiration cytology of palatine tonsils: a study of 112 consecutive adult tonsillectomies.

OBJECTIVE: To study fine needle aspiration cytology (FNAC) findings of tonsillar lesions with histological controls and to assess its role in the diagnostic evaluation of tonsillectomy specimens. METHODS: This study consisted of 112 cases that required tonsillectomy, comprising 55 (49.1%) men and 57 (50.9%) women. The ages ranged between 20 and 62 years. The clinical diagnosis in 101 cases was chronic tonsillitis, whereas 11 were suspected of neoplasia. FNAC was performed before tonsillectomy under general or local anaesthesia or on fresh specimens using a 21-G needle. The smears were stained using Wright-Giemsa and Papanicolaou methods. Histological examination was carried out on surgical specimens of all cases and, when required, immunohistochemistry was performed on histological sections. The diagnostic outcomes between FNAC and surgical biopsy were compared. RESULTS: In this study, 106 cases were diagnosed as chronic tonsillitis/follicular hyperplasia, four cases as non-Hodgkin's lymphoma, one as Hodgkin's lymphoma and one as monophasic synovial sarcoma. All malignant cases were diagnosed by FNAC, but synovial sarcoma was incorrectly diagnosed as squamous cell carcinoma. Five cases clinically suspected of neoplasia were correctly diagnosed as chronic tonsillitis on cytology. CONCLUSION: Tonsillar aspiration is a safe procedure and is useful in the evaluation of tonsillectomy specimens. However, ancillary tests on cytological material are often needed when neoplasia is suspected and would help clinical management and allow histological examination of cases diagnosed cytologically as lymphoma.

Double-phase Tc-99m-SestaMIBI SPECT imaging in a case of glomus jugulare tumor.

We performed a double-phase Tc-99m-SestaMIBI SPECT study on a patient who presented with a mass located at the skull base. The results were compared with double-phase T1-201 SPECT study. Early phase (30 min) SPECT images of both radiopharmaceuticals demonstrated increased radiotracer uptake in the region of the tumor. However, late images (180 min) revealed rapid wash-out of Tc-99m-SestaMIBI from the tumor, suggestive of a benign vascular tumor, while T1-201 images showed slower wash-out. Tc-99m-SestaMIBI SPECT findings were also confirmed by carotid angiography and biopsy, while a contemporaneous MRI scan was inconclusive in differentiating benign from malignant tumor. Initial and one-year follow-up whole body CT scans were negative for any metastatic sites, supporting the diagnosis of benign glomus jugulare tumor.

Serum levels of interleukin-7 and interleukin-8 in head and neck squamous cell carcinoma.

Background: The aim of this study was to investigate the association of head and neck squamous cell carcinoma (HNSCC) with serum levels of interleukin-7 (IL-7) and IL-8, the two cytokines whose associations with HNSCC need more clarifications. Materials and Methods: Commercial enzyme-linked immunosorbent assay kits were used for the quantification of the cytokines. Sera were collected from 48 untreated patients (36 men and 12 women; mean age: 52.7 ± 9.8 years) and 34 healthy donors (26 men and 8 women; mean age: 53.1 ± 9.0 years). Results: Serum IL-8 level was neither significantly different between HNSCC patients and control individuals nor associated with smoking status, gender, age, tumor location, tumor grade, and stage of the patients (P > 0.05). Regarding IL-7, all control individuals had serum levels below the sensitivity of the kit (3 pg/ml), but nine patients had detectable levels, and that the mean serum IL-7 was significantly higher in the patients compared to the controls (P = 0.008). Conclusions: Serum IL-8 level is not significantly associated with HNSCC. With the sensitivity of the kit we employed, it seems that serum IL-7 levels are specifically elevated in HNSCC patients compared to healthy individuals. Data from other independent studies are required to clarify the possible employment of IL-7 as an HNSCC biomarker.

Serum levels of interleukins 4 and 10 in head and neck squamous cell carcinoma.

OBJECTIVE: There is currently controversy over the association between serum interleukin-4 and -10 levels and head and neck squamous cell carcinoma in patients of different ethnicity. This study aimed to investigate serum levels of these cytokines in Iranian patients with this pathology, and to analyse correlations with tumour location and tumour stage at diagnosis. DESIGN: Serum cytokines levels were quantified using commercial enzyme-linked immunosorbent assays. SUBJECTS: Study groups comprised 93 untreated patients and 53 healthy donors. RESULTS: Serum interleukin-4 levels were significantly increased in patients compared with controls (p < 0.000), but were not significantly associated with tumour stage. Serum interleukin-10 levels were not raised in patients, nor associated with tumour stage. CONCLUSION: Serum levels of interleukin-4, but not -10, were increased in Iranian head and neck squamous cell carcinoma patients. These data do not support an association of these cytokines with tumour progression; this is consistent with previous findings.

Differentiation of adipose-derived stem cells into ear auricle cartilage in rabbits.

BACKGROUND: Adipose-derived stem cells have been reported as a novel candidate for the repair of cartilage injuries in vivo. METHODS: In order to assess their differentiation ability, adipose-derived stem cells isolated from rabbit fat tissue were injected into the midportion of a surgically created rabbit ear auricle cartilage defect. After several months, the auricles were resected, histopathologically assessed and compared with a control group. RESULTS: Histopathological examination of auricles removed three, four and five months after injection showed islands of new cartilage formation at the site of the surgically induced defect. Six months after injection, we observed well-formed, mature cartilaginous plates that completely filled the defect in the native cartilage. In the control group, there was no significant growth of new cartilage. CONCLUSION: The results of this study suggest the great potential of adipose-derived stem cells to repair damaged cartilage tissue in vivo.

Distant metastases to nasal cavities and paranasal sinuses case series.

Metastatic tumors to the nasal cavity and paranasal sinuses are far less common than primary cancer in this location. Review of the 2004-2010 pathology records of patients with sinonasal malignancy, revealed three cases with distant metastases to this region from primary sites in kidney, prostate and breast. The clinical presentation, histopathological findings and clinical outcome is presented for each patient. Metastases to the nose and paranasal sinuses usually respond poorly to treatment and have a poor prognosis. This report highlights the importance of suspecting metastases in patients with a previous history of malignancy. Therefore, thorough history and clinical evaluation is mandatory in any known/treated case of cancer.

Relation between Actinomycosis and Histopathological and Clinical Features of the Palatine Tonsils: An Iranian Experience.

BACKGROUND: Actinomycosis of the tonsils has been reported in a variable percentage of tonsil specimens by other authors. This study determines the incidence of actinomyces in the palatine tonsil and evaluates the clinical diagnoses and histopathological features of tonsillectomy specimens. METHODS: In a retrospective study, 204 patients who had undergone tonsillectomy for recurrent tonsillitis (group A) and for sleep apnea without a history of recurrent tonsillitis (group B) were enrolled. RESULTS: The prevalence rate was significantly higher in the adult compared with the pediatric population. The prevalence of tonsillar actinomycetes colonization was higher in patients who had undergone tonsillectomy for recurrent tonsillitis (43.9%) than in patients who had undergone tonsillectomy for obstructive sleep apnea (26.3%). The prevalence did not differ by sex of patient. Histopathological analysis of resected tonsils did not show active tissue infection. There was a statistically significant relationship between the presence of actinomycosis and age, with a greater occurrence of actinomycosis in adult patients. CONCLUSION: Although actinomyces colonization is more prevalent in patients with recurrent tonsillitis than sleepdisordered breathing, but the presence of actinomyces does not indicate any active disease.

Squamous cell carcinoma associated with tall cell variant of papillary carcinoma of the thyroid.

We report the simultaneous occurrence of the tall cell variant of papillary carcinoma and squamous cell carcinoma in the thyroid gland. Histology and immunohistochemical findings are discussed and it seems that the malignant squamous component was transformed from the tall cell variant of papillary carcinoma. Metastasis from the squamous cell carcinoma is diagnosed in the regional lymph node.

Head and neck squamous cell carcinoma is not associated with interleukin-18 promoter gene polymorphisms: a case-control study.

OBJECTIVE: To investigate the association of two functional single nucleotide polymorphisms in the promoter region of the interleukin-18 gene, at positions -607 and -137, with head and neck squamous cell carcinoma. DESIGN: Genomic deoxyribonucleic acid was extracted, by the salting-out method, from peripheral blood leukocytes. Single nucleotide polymorphisms of the interleukin-18 gene at positions -607 (cytosine/adenine) and -137 (guanine/cytosine) were analysed by sequence-specific polymerase chain reaction. SUBJECTS: One hundred and eleven patients (86 men and 25 women; mean age 56.7+/-13.7 years) and 212 regional controls (165 men and 47 women; mean age 53.3+/-12.2 years) were studied. Control subjects comprised healthy volunteers or cancer-free individuals presenting with otolaryngological disease. The diagnosis of squamous cell carcinoma was confirmed histopathologically. Various clinical parameters were collected at diagnosis, including tumour site, tumour size, lymph node involvement, distant metastasis and stage. RESULTS: There was no significant association between the allele, genotype or haplotype frequencies of the two single nucleotide polymorphisms of the interleukin-18 promoter and the head and neck squamous cell carcinoma susceptibility or clinical parameters at diagnosis. CONCLUSION: Interleukin-18 polymorphisms at positions -607 and -137 did not confer susceptibility to head and neck squamous cell carcinoma in southern Iranian patients.

Histopathological screening of tonsillectomy and/or adenoidectomy specimens: a report from southern Iran.

BACKGROUND: The need for pathologic examination of all tonsillectomy and/or adenoidectomy (T&A) specimens is controversial. Microscopic pathologic examination of these specimens is costly, but neglecting this step may miss diagnoses of significant diseases, especially malignancies. This study was designed to determine the rate of unexpected malignancies among patients who underwent T&A. METHODS: All patients who underwent T&A at Shiraz University of Medical Sciences between February 2004 and February 2008 were included in a prospective study. Gross and microscopic pathologic examinations were done on all the specimens. The charts of the patients with significant pathological finding were reviewed. Information about pre-operative signs, symptoms, and risk factors were used to verify unexpected pathologic findings. RESULTS: A total of 5058 patients were included. The age distribution was 10 months to 92 years (mean 14.0 years). There were 2498 males (49.4) and 2560 females (50.6%). Significant pathological findings were detected in 54 patients (1%). One unexpected malignancy (0.019%) was found in an adult patient. No unexpected malignancies were found in pediatric patients. CONCLUSIONS: All T&A specimens in the adult population should be sent for microscopic pathological examination. Also specimens of nonroutine T&A in children (with positive findings in the medical history or on physical examination) should be sent for microscopic pathological examination. In children without positive findings in their history or on physical examination, gross pathological evaluation of routine T&A specimens by a pathologist is sufficient.