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Salivary Gland Tumors
Published in Dongyou Liu, Tumors and Cancers, 2017
ACC (formerly cylindroma) is the most common malignant salivary gland tumor of the minor salivary glands. Macroscopically, ACC is a small, poorly circumscribed or encapsulated and infiltrative, 1–8 cm in size, locally aggressive tumor. Histologically ACC demonstrates three growth patterns: tubular, cribriform (classic), and solid (basaloid). The cribriform pattern is the most common and has epithelial cell nests in cylindrical formation. The tubular pattern contains tubular structures lined by stratified cuboidal epithelium. The solid pattern is the least common and of high grade, displaying solid groups of cuboidal cells. Apart from small bland myoepithelial cells with scant cytoplasm and dark compact angular nuclei surrounding pseudoglandular spaces with PAS+ excess basement membrane material and mucin, ACC shows peripheral perineural invasion and small true glandular lumina; absence of squamous differentiation and extensive necrosis (presence of pseudoglandular lumina, true glandular lumina, and perineurial invasion is diagnostic). Dedifferentiated tumor may have irregular tumor islands composed of anaplastic cells with abundant cytoplasm and desmoplastic stroma. ACC stains positive for keratin, CEA, S100, CK7/CK20, etc., but negative for estrogen and progesterone receptors. Molecularly, ACC is associated with deletion and/or translocation on the long arm of chromosome 6 and altered p53 expression [6].
The efficacy of OK-432 sclerotherapy on thyroglossal duct cyst and the influence on a subsequent surgical procedure
Published in Acta Oto-Laryngologica, 2019
Tomoyasu Tachibana, Shin Kariya, Yorihisa Orita, Takuma Makino, Takenori Haruna, Yuko Matsuyama, Yasutoshi Komatsubara, Yuto Naoi, Michihiro Nakada, Yoji Wani, Soichiro Fushimi, Machiko Hotta, Katsuya Haruna, Tami Nagatani, Yasuharu Sato, Kazunori Nishizaki
The present study has some limitations. First, pathological study was performed only for cases with poor or no response to OK-432 sclerotherapy. Although the pathological changes in patients that responded to OK-432 sclerotherapy were not examined, they might be similar to those in patients resistant to the therapy. Regarding the epithelial lining of TDC, it has been reported that 53% of TDC cases was lined with PCE, 18.8% with SSE, 18.8% with both PCE and SSE, and 9.4% with stratified cuboidal epithelium [11]. Second, the number of cases treated with OK-432 sclerotherapy was too small. This might be explained by the fact that sclerotherapy sometimes requires repeated treatments. In the present study, OK-432 injection was performed up to six times in one patient. Patients with inefficient time for treatment may undergo surgical treatment without OK-432 sclerotherapy as the initial treatment. However, surgery for neck cystic lesions is recommended for cases with poor or no response to OK-432 therapy [6]. In the future, further accumulation of TDC cases treated with OK-432 sclerotherapy is necessary for more accurate analysis. In addition, histological analysis would be helpful in the identification of the prognostic factors associated with the effects of OK-432 sclerotherapy on TDC.