Combination chemotherapy of carboplatin and paclitaxel for advanced/metastatic salivary gland carcinoma patients: differences in responses by different pathological diagnoses

Background: A standard chemotherapy for recurrent/metastatic salivary gland cancers has not been established. Combination chemotherapy of carboplatin and paclitaxel should be evaluated as a treatment option.

Methods: This study retrospectively reviewed salivary gland cancer patients who received combination chemotherapy of carboplatin and paclitaxel. The differences in objective responses and in the prognoses according to the different pathological diagnoses were evaluated.

Results: A total of 38 patients were enrolled in the study; of them, 18 had salivary duct carcinomas (SDCs), nine had adenoid cystic carcinomas (ACCs), and 11 had other pathological diagnoses. Objective responses were observed in 15 (39%) patients. The median progression-free survival (PFS) was 6.5 months, and the median overall survival (OS) was 26.5 months. ACC patients had relatively low response rates (9%), but there were no significant differences in PFS or OS compared to other sub-types. The treatment was well tolerated, with few adverse events.

Conclusion: Salivary gland cancer patients showed a moderate clinical response to the combination chemotherapy of carboplatin and paclitaxel. The objective response rates differed according to the pathological diagnoses, but there were no significant differences in prognoses.     

肾上腺节细胞神经瘤的CT及MRI诊断

目的 总结分析肾上腺节细胞神经瘤的CT和MRI表现,提高对本病的认识.方法 回顾性分析经手术病理证实的5例肾上腺节细胞神经瘤患者的CT和MRI表现.3例患者行CT平扫及增强扫描,2例患者行MRI平扫及增强扫描.结果 5例病灶均为单发,位于右侧肾上腺者3例,左侧肾上腺者2例.病灶呈圆形、椭圆形或不规则形,边界清楚.CT平扫密度低于肌肉组织,增强扫描动脉期无明显强化,静脉期、延迟期呈轻度强化;2例肿块见条状、点状钙化.2例行MRI扫描的病例中,病灶T1WI呈低信号,T2WI呈高或稍高信号,增强扫描动脉期病灶无明显强化,静脉期、延迟期呈轻度强化.结论 CT、MRI能很好地显示肾上腺节细胞神经瘤的影像学特点,并能清晰显示病灶与周围组织结构的关系,有助于和肾上腺其他病变的鉴别.     

Preoperative diagnostic values of fine-needle cytology and MRI in parotid gland tumors

The aim of this retrospective study was to assess and compare the diagnostic value of fine-needle cytology and MRI for the prediction of malignancy in parotid tumors. During an 11-year period, 148 patients underwent preoperative fine-needle aspiration cytology in our institution. Eighty-seven patients underwent a preoperative MRI study, and 54 had both MRI and cytology. The study compares results of cytology and MRI with histological reports. The sensitivity, specificity and accuracy for detecting malignant lesions were 87, 94 and 93% respectively for MRI, 81, 95 and 92% respectively for cytology and 100, 88 and 91% respectively for both studies combined. Fine-needle cytology provided better information than MRI concerning precise histological diagnoses. Conversely, the proportion of non-diagnostic smears reached 10%. Fine-needle cytology and MRI are simple, well-tolerated diagnostic means with an impact on the management of salivary gland tumors. The associated anatomic information obtained by MRI imaging makes it the test of first choice in an optimal medical environment.     

Sodium selenite is a potent radioprotector of the salivary glands of the rat: acute effects on the morphology and parenchymal function during fractioned irradiation

In vitro studies show that sodium selenite is a potential radioprotector in normal cultural cells, but not in tumor cells. The aim of this study was to evaluate the cytoprotective potency of sodium selenite during a conventional fractioned irradiation of the salivary glands of rats. The head and neck area of male WAG/RijH rats was irradiated with ⁶⁰Co- rays (60 Gy/30 fractions/6 weeks). Sodium selenite (15 µg/kg body weight) was applied through a venous port 30 min before irradiation. Rats of a control group were treated in the same manner with an equal volume of physiologic sodium chloride. In the course of treatment, the salivary glands were resected at different stages and examined histopathologically. The evaluation of gland function was performed prior to and after radiotherapy by sialoscintigraphy. The irradiation caused dose-dependent damage in the salivary glands. Intra- and intercellular edema (16 Gy), vacuolization (30 Gy), degranulation (46 Gy) and necrosis of the acinar cells (60 Gy) occurred. Sodium selenite delayed the development of the described damage; additionally, the number of necrotic acinar cells after the application of 60 Gy was reduced (control, 75% vs. sodium selenite, 30%). The sialoscintigaphical results confirmed these results: the loss in gland function in the control group was 74 vs. 44% (P<0.05) in the sodium selenite group. Based on the morphological and sialoscintigraphical findings, a cytoprotective effect on the acute toxicity of the salivary glands of rats could be detected during irradiation with synchronous application of sodium selenite.     

Salivary cortisol and aggression in a population-based longitudinal study of adolescent males

Summary. Chronic antisocial behaviour in youth has been associated with cortisol, a measure of stress reactivity. However, some studies have found low cortisol levels, while others have found elevated cortisol levels. The present study compared variously defined aggressive subgroups for differences in salivary cortisol. A population-based sample of boys was followed longitudinally from childhood to adolescence. Assessments of different forms of antisocial behaviour were obtained from various informants at several points in time, and cortisol was collected at age 13. Higher cortisol levels were found in boys with conduct disorder (CD) than in boys without CD. In addition, boys with an aggressive form of CD had higher cortisol levels than boys who showed a covert form of CD. Furthermore, reactive aggression was strongly correlated with elevated cortisol. Adolescent boys with chronic reactive aggression and those who scored high on aggressive CD symptoms seem to have a more active hypothalamic-pituitary-adrenal system.     

Dynamic imaging with sialography combined with sialendoscopy to manage a foreign body in Stensen's duct

Objective

We describe sialography as a dynamic imaging modality useful in establishing the diagnosis and planning for treatment of a parotid gland ductal foreign body.

涎腺细针吸取细胞学分类诊断价值和存在问题

目的 分析涎腺疾病细针吸取细胞学（FNAC）形态学特点和准确分类,探讨涎腺FNAC的诊断价值和存在问题。方法 回顾113例涎腺FNAC形态学特征、免疫表型和分类诊断,并结合临床、组织病理学分析。结果 FNAC失败2例,诊断非肿瘤12例、肿瘤99例（良性肿瘤82例,恶性17例）。富于细胞多形性腺瘤、腺样囊性癌和基底细胞腺瘤相似,鉴别诊断困难。腮腺淋巴上皮癌与未分化型鼻咽型鳞状细胞癌转移完全一致,鉴别需结合临床分析。与组织学比较发现,FNAC误诊3例,分别为淋巴结反应性增生疑为非霍奇金淋巴瘤、黏液表皮样癌诊为“少量异型细胞”和淋巴上皮癌疑为良性淋巴上皮病变。FNAC区分良、恶性准确率97．4％（110／113）,良性病变99．0％（95／96）,恶性肿瘤88．2％（15／17）。总体分类准确率90．3％（102／113）,特异性91．9％（102／111）;良性病变准确率91．7％（88／96）,特异性92．6％（88／95）;恶性肿瘤准确率82．4％（14／17）,特异性87．5％（14／16）。结论 FNAC诊断涎腺良、恶性病变敏感、可靠,可提供准确的分类诊断,但诊断某些肿瘤仍有局限性,需要活检证实。     

Immunohistochemical demonstration of S-100 protein in salivary gland neoplasms

A peroxidase-antiperoxidase technique for S-100 protein has been applied to 68 salivary glands. These included 17 pleomorphic adenomas, seven adenoid cystic carcinomas, 23 adenolymphomas and a number of other neoplasms. In addition, five specimens of myoepithelial sialadenitis ('benign lymphoepithelial lesion') and five normal parotid glands were included. Consistent results were obtained, myoepithelial cells and cells in myxoid and chondroid areas in pleomorphic adenomas staining intensely. In adenoid cystic carcinoma, on the other hand, there was no staining. The adenolymphomas possessed intensely S-100 protein-positive cells in the interfollicular lymphoid areas; these were probably interdigitating reticulum cells. In addition, branching structures, probably corresponding to Langerhans' cells, were observed in the epithelium of adenolymphomas.     

Warthin tumor exhibiting sebaceous differentiation and necrotizing sialometaplasia

Summary A case of a Warthin tumor exhibiting sebaceous differentiation and necrotizing sialometaplasia is presented. This case suggests a common histogenesis for the Warthin tumor and sebaceous lymphadenoma. It supports the theory that necrotizing sialometaplasia is caused by factors which compromise or obstruct the blood supply to salivary gland tissues. The literature on sebaceous differentiation in Warthin tumor and on necrotizing sialometaplasia is reviewed.