Sarcoidosis of the upper respiratory tract in children

Sarcoidosis is a multisystemic granulomatosis of unknown etiology which mainly affects young adults. It is characterized primarily by bilateral hilar adenopathies, a pulmonary infiltrate and cutaneous and ocular lesions. It rarely occurs in children under the age of 16. Localization in the upper respiratory tract (URT) is infrequent and sarcoidosis of the URT in children is exceptional, with only 13 cases reported in the literature. In the present report we describe the clinical, diagnostic explorations, histological and therapeutic aspects of 2 new cases in children.     

Immunoassay of lymphocyte subsets in ovine palatine tonsils

By means of immunohistochemistry (IHC) and triple color flow cytometry (FCM), five commercial antibodies (anti-CD2, CD4, CD8, CD21, and CD45) were evaluated to quantify and localize the B- and T-lymphocytes in the ovine palatine tonsil. The results of both techniques were compared and evaluated. For the immunohistochemical analysis, three fixation methods were evaluated for their suitability to localize the different lymphocyte populations: 3.5% formaldehyde, zinc salts-based fixative and cryopreservation. The anti-CD45 antibody showed a positive reaction after all three fixation methods. The four other antibodies tested (anti-CD2, CD4, CD8 and CD21) were compatible with zinc salts-based fixation and cryopreservation. The CD21+ B-lymphocytes were localized in the tonsillar lymphoid follicles, while the CD2+ T-lymphocytes were abundant in the interfollicular regions and rare within the lymphoid follicles. The CD8+ T-cells were concentrated adjacent to the follicles, while the CD4+ T-cells were localized in the interfollicular zones as well as in the follicles. Both by immunohistochemistry and flow cytometry, a quantification of the different lymphocyte subsets was made. When comparing the results, a reversed B/T cell ratio was noticed. Possible explanations for this observation are discussed.     

Human Papillomavirus (HPV) Related Carcinomas of the Upper Aerodigestive Tract

Epidemiologic, clinical, morphologic and molecular evidence show that high risk HPV, particularly type 16, is a prerequisite for some carcinomas of the upper aerodigestive tract (UADT), particularly tonsil and base of tongue. Sexual transmission is an important mode of infection while tobacco use and excessive drinking are not considered risk factors. HPV + tumors are distinct clinically and pathologically. They are more common in young patients (<40 years) with a male to female ratio of 4:1. They usually present as a small or occult primary tumor with advanced neck disease. Microscopically they are non-keratinizing squamous cell carcinomas with basaloid features, excessive mitosis and comedo type necrosis. The tumors have a distinct immunohistochemical profile characterized by strong and diffuse p16 reactivity, low or negative p53 staining and high Ki67 labeling scores. HPV + carcinomas are more radio-sensitive and have a better prognosis than the classical keratinizing SCC of the UADT. An anti-HPV vaccine has recently been made available for prevention of cervical cancer. The impact of the vaccine on the prevalence of HPV related carcinomas of the UADT is currently not known but likely beneficial.     

Human papillomavirus in tonsillectomy specimen from China and Pakistan — Prevalence and genotype distribution

Background

The expected corresponding increase in tonsillar human papillomavirus (HPV) infection associated with increasing incidence of oropharyngeal squamous cell carcinoma (OPSCC) substantiate the evaluation of normal tonsillar tissue in different population. The epidemiology of HPV in tonsillar tissue varies geographically. This study evaluated samples from two countries to determine the prevalence in respective samples.

Prevalence of Epstein-Barr virus in tonsils and adenoids of United Arab Emirates nationals

Objective

Given that Epstein-Barr virus (EBV) often inhabits human tonsils and adenoids, it remains to be distinctively determined its prevalence and in which cell and microenvironment the virus is present.

Methods

To determine the prevalence of EBV in the tonsils and adenoids of the United Arab Emirates (UAE) nationals and to provide a basis for understanding the origin and biology of EBV-infected cells, the immunophenotype of all EBV-infected cells in 46 tonsils and 46 adenoids was determined by EBER in situ hybridization and immunohistochemistry with monoclonal antibodies to T cells (CD3), B cells (CD20), and epithelial cells (cytokeratin AE1/AE3), as well as immunostaining with antibodies to EBV latent membrane protein-1 (LMP-1).

Results

EBV was found in 43% of tonsillectomy specimens and 15% of adenoidectomy specimens. All EBV-infected cells were found to be B lymphocytes. About 90% of the infected B cells are found in the interfollicular regions of tonsils and adenoids and the remaining 10% are found within the follicles. There is no significant association between EBV infection, age (P = 0.324) and gender (P = 0.442).

Conclusion

EBV is associated with tonsillar hypertrophy and is prevalent in 43% of our cases. EBV is only detected in B lymphocytes and we believe that B lymphocytes are sites of primary infection and latency. In situ hybridization is the gold standard for the detection of EBV in tissue.     

Tonsillar colonization is unlikely to play important role in Helicobacter pylori infection in children

OBJECTIVE: To determine (i) seroprevalence of Helicobacter pylori (HP) infection in children undergoing tonsillectomy, (ii) possible HP colonization on tonsils of children and its importance in HP transmission, and (iii) if four examined socio-economic factors are the risk factors for HP transmission and HP colonization on tonsils in children. METHODS: Rapid urease test (RUT) of tonsils, and serologic blood tests for HP were performed in 77 children (aged 4-14 years) in Bosnia and Herzegovina (B-H), undergoing tonsillectomy. RUT positive tonsils were cultured for HP. RUT positive children were tested using (13)Carbon-urea breath test ((13)C-UBT). Information about socio-economic potential risk factors was obtained from the parents. RESULTS: Out of 139 pharyngeal and palatine tonsils, 17 palatine tonsils in 14 children were RUT positive and had negative HP culture. Eight children had positive both RUT and (13)C-UBT. There was no significant difference between children with hypertrophy and those with recurrent tonsillitis comparing their serologic tests results. There was no significant difference between seronegative (n=61) and seropositive (n=16) children comparing their age, sex, parental education level, owning a family courtyard, attending a children's collective, and owning a pet cat. CONCLUSIONS: The results in this prospective study do not support the notion that tonsils are an important reservoir for HP transmission in children in B-H. The examined socio-economic factors did not enhance HP seropositivity rate in children.     

Fas配体和细胞黏附分子1在肥大扁桃体组织高内皮小静脉中的表达及意义

目的：探讨Fas配体（FasL）和细胞黏附分子1（ICAM-1）在肥大扁桃体组织高内皮小静脉（HEV）中的表达及意义。方法：收集37例扁桃体切除标本,其中20例为慢性肥大性扁桃体炎患者（CHT组）,17例为特异性扁桃体肥大患者（ITH组）。应用苏木精-伊红染色法和免疫组织化学染色（SABC法）研究2组扁桃体组织HEV的T、B淋巴细胞的数目,内皮细胞中FasL及ICAM-1的表达。结果：CHT组HEV中ICAM-1的表达明显高于ITH组（P〈0.05）,而ITH组HEV中FasL的表达明显高于CHT组（P〈0.05）。结论：HEV内皮细胞表达的ICAM-1和FasL均可能在扁桃体肥大的发生、发展过程中起一定的促进作用,前者主要促进CHT发展,后者主要导致ITH。     

低温等离子消融术在儿童鼾症手术中的应用

目的评价低温等离子消融术治疗小儿鼾症的疗效。方法多导睡眠呼吸监测确诊的82例患儿,在全麻下采用Arthrocare等离子刀系统行扁桃体摘除术,在70度鼻内镜辅助下行腺样体射频消融术。所有患儿均随访6月,总结术后并发症及其临床疗效。结果82例患儿中,1例患者术后第2天发生出血,1例患者术后第6天继发出血,其余患者无任何手术并发症。随访结果显示,82例患儿临床症状均得到改善。结论等离子消融手术时间明显缩短,术中出血量减少,是治疗儿童鼾症的有效方法。