Adenoid Research Articles

Secondary analysis of airway obstruction in children with adenoid hypertrophy: Association with jaw size and position

Rising information on the potential of the environment to influence phenotypical expression invited revisiting prior data on the effect of airway obstruction on jaw size, not only position. AimEvaluate the jaw interactions in response to graded airway obstruction and their effect on jaw size. Methods200 consecutively examined mouth-breathing children (age: 6.00 ± 2.62years) were referred by the pediatric otorhinolaryngologist for lateral cephalometric assessment of adenoid hypertrophy. Cephalometric measurements included maxillary and mandibular lengths, inclinations of palatal and mandibular planes and as airway measurement, the shortest distance from soft palate to adenoid (AD). Three severity groups were categorized on airway clearance level: AD1: >6mm, AD2: 2-6 mm, AD3: ≤2mm. All parameters were compared among the groups and to control databases. Statistics included one-way analysis of variance for group differences, linear and multiple regressions for associations and prediction models. ResultsAge was statistically significantly different (p < 0.001) among groups (AD1: 7.72 ± 3.02years; AD2: 5.89 ± 2.42years; AD3: 5.13 ± 2.21years). Cephalometric measurements in AD1 and AD2 were closest to normative data over time; the most severe AD3 diverged from these data. Variation in AD was accounted for by the combination of age and either mandibular length Co-Gn (59.4%) or maxillary length ANS-PNS (43.4%). Predictors of Co-Gn included the combination of ANS-PNS and AD (64.8%), and that of age, AD and palatal plane cant (62.4%). ConclusionThe results suggest that reduced nasopharyngeal clearance affects maxillary and mandibular size, the latter directly influenced by the maxillary changes.

Notch inhibitors induce diarrhea, hypercrinia and secretory cell metaplasia in the human colon.

In humans, inhibition of Notch oncogenic signaling leads to tumor regression. Preclinical studies indicate that Notch signaling contributes to the maintenance of intestinal homeostasis. Here, we sought to describe the intestinal effects of a first-in-human Notch inhibitor in an indication of refractory cancer. Between 2014 and 2017, adult patients treated for refractory cancer with the novel Notch inhibitor LY3039478 and who had grade ≥ 2 diarrhea were referred to the gastroenterology department of a tertiary hospital in the Paris region of France. Eleven patients (median (range) age: 72 (29-83)) were included in the study. All patients had advanced cancer: adenoid cystic carcinoma (n=3, 27 %), sarcoma (n=3, 27 %), and other types (n=5, 46 %). In all cases, digestive tract endoscopy revealed abundant mucus in the intestinal lumen, and digestive tract biopsies showed an abnormally low proportion of enterocytes and marked elevation of the proportion of pseudostratified goblet cells. Microscopic inflammation was seen in colon biopsies from 2 of the 11 patients (18 %). The clinical, endoscopic and histological abnormalities were dependent on the dose of Notch inhibitor. All patients resolved their digestive signs or symptoms after discontinuing the dose and the median (range) time interval between discontinuation of the Notch inhibitor and resolution of all the gastrointestinal signs and symptoms was 7 days (4-24). Likewise, the median time interval between discontinuation and resolution of the histological abnormalities was 7 days (1-10). Blocking Notch signaling induces secretory cell metaplasia of the intestinal epithelium, which in turn leads to transient diarrhea. Our results confirm the role of Notch signaling in intestinal homeostasis in humans.

Association of lip posture and the dimensions of the tonsils and sagittal airway with facial morphology.

The specific contribution of enlarged tonsils or adenoids to craniofacial growth remains unknown, and there is no agreement in the literature as to the significance of lip posture. This study assessed the separate associations of lip posture, sagittal airway size, and tonsil size with selected cephalometric measures. Clinical and cephalometric data of 207 children who presented for evaluation of tonsil and/or adenoid problems were evaluated. Multiple linear regression was used to assess the linear relationship between each of the three parameters and the cephalometric dependent variables. Open lip posture, reduced sagittal airway, and large tonsils were each associated statistically with a characteristic but different skeletal configuration. This association was proportional. Specifically, a more open lip posture was associated with a more backwardly rotated face and larger lower facial height. Reduced sagittal airway size was associated with en bloc backward relocation of the maxilla and mandible. Because the sella-nasion dimension shortened proportionally, the SNA and SNB angles were not affected. Larger tonsils were associated with more forward relocation and rotation of the maxilla and mandible and increased SNA and SNB angles. Because each of the three parameters was associated proportionally with a different craniofacial morphology, it is concluded that lip posture, sagittal airway size, and tonsil size represent three different and unrelated phenomena with respect to their effects on craniofacial growth and form.

Cervical lymph node metastasis in adenoid cystic carcinoma of the salivary glands: A clinicopathologic study

To investigate the incidence and clinicopathologic features of cervical lymph node metastasis in salivary gland adenoid cystic carcinoma (AdCC). Retrospective analysis was made in 798 AdCC patients who underwent tumor resection during January, 2001 to January, 2019 in Peking University School and Hospital of Stomatology, especially the clincopathologic characteristics of 82 cases with lymph node metastasis. In the study, 82 of the 798 patients were identified with cervical lymph node metastasis, which was confirmed by histopathological examination. The palate, the region of sublingual gland and mouth floor, and the parotid were the frequently involved primary sites for AdCCs. The general incidence rate of lymph node metastasis was approximately 10%. The submandibular gland, the region of sublingual gland and mouth floor, and the mobile tongue were the most frequent sites of lymph node metastasis with the incidence rates of 20.8%, 16.1%, and 15.1%, respectively; while lymph node metastasis was uncommon in the tumors which were the origin from the palate and parotid, with incidence rates of 6.1% and 3.4%, respectively. Most AdCC cases (70.7%) showed the classic "tunnel-style" metastatic pattern of occurrence, and the level I and II regions were the most frequently involved areas. The 5-year and 10-year overall survival rates of the patients with lymph node metastasis were 77.4% and 20.6% respectively, while the 5-year and 10-year overall survival rates of the patients with no lymph node metastasis were 83.5% and 57.6%, respectively. The univariate analysis demonstrated that statistically significant differences in the overall survival for the presence of lymph node metastasis (P<0.001). In the meantime, the 5-year disease-free survival rate of the patients with lymph node metastasis also showed statistically significant differences to that of the AdCC patients with no lymph node metastasis. In addition, the primary site and histological grade were significantly associated with lymph node metastasis, and the high-grade solid growth pattern was identified as a strong predictor for the occurrence of lymph node metastasis. Cervical lymph node metastasis has a high tendency of occurrence in submandibular gland and tongue-mouth floor complex, and the high-grade solid growth pattern could be taken as a strong predictor for the occurrence of lymph node metastasis, which correlates to poor prognosis of AdCC patients. A selective neck dissection should be considered as a management in such patients.

Roles of Proteoglycans in the Tumourigenesis and Development of Adenoid Cystic Carcinoma and Pleomorphic Adenoma of the Salivary Gland: A Systematic Review.

Salivary adenoid cystic carcinoma (ACC) and pleomorphic adenoma (PA) are the most common types of salivary gland tumours; the former is malignant and the latter is benign but with features of a border tumour. Proteoglycans (PGs) produced by neoplastic myoepithelial cells are ubiquitous in both types of tumours. However, normal myoepithelial cells of salivary glands do not have the ability to secrete PGs. When the synthesis of PGs is blocked, the pulmonary metastasis and perineural growth of salivary ACC as well as the implanting growth of salivary PA are inhibited, highlighting the important functions of PGs in the tumourigenesis and development of these two tumours. In this review, we summarise literature from the past 40 years, including more recent findings from our laboratory, to clarify the pivotal roles of PGs produced by neoplastic myoepithelial cells in both the histogenesis and biological behaviours of ACC and PA.

Recurrent respiratory infections in children: a study in clinical practice.

Recurrent respiratory infections (RRI) are very frequent in childhood. RRI are commonly associated with some co-morbidities and typical clinical features. This study aimed to test the hypothesis whether an ENT visit could identify predicting factors for IRR. Globally, 1,002 children (550 males, mean age 5.77 years) were consecutively visited at an ENT clinic. Clinical visit, nasal endoscopy, and skin prick test were performed in all patients. RRI were present in 633 (63.5%) children. Some parameters were predicting factor for RRI: male gender (OR=1.68), tonsil and adenoid volume, even if partially for some volume grading. On the other hand, familiar atopy (OR=0.68), acute otitis media (OR=0.29), and certain tonsil and adenoid size (OR range 0.68-0-47) seemed to be protecting factor for RRI. This real-life study showed that during an ENT visit it is possible to identify some predictive factors involved in RRI: some seem to be protective, whereas other seem to be predisposing. (www.actabiomedica.it)

Correlation between adenoid hypertrophy, maxillary sinus mucosal thickening and dentofacial development in children

PURPOSE：To investigate the effects of adenoid hypertrophy and maxillary sinus mucosal thickening on dentofacial development. METHODS：The selected subjects were divided into 4 groups according to the inclusion criteria: group A (adenoid hypertrophy with maxillary sinus mucosal thickening), group B (adenoid hypertrophy without maxillary sinus mucosal thickening), group C (normal adenoid with maxillary sinus mucosal thickening), and group D (normal adenoid without maxillary sinus mucosal thickening). There were 20 subjects in each group, aging from 12 to 14 years old. The volume of maxillary sinus was measured by Mimics software. The adenoid, dental arch width, basal bone width and palatal height were measured by Dolphin software and dentofacial measurements were performed in the lateral cephalograms derived from cone-beam CT (CBCT). The data were analyzed with SPSS 24.0 software package. RESULTS： There was no significant difference in dentofacial measurements between group B and group D or group C and group D，except for ANB angle (P<0.05). Compared with group D, SNB, ANB, Wits appraisal, NA-APo, MP-HP, N-Me, S-Go/N-Me, N-ANS (perp HP), sum of three angles, Ar-Go of group A were significantly different (P<0.05). Neither left nor right maxillary sinus bony volume had significant difference between group B and D or group C and D. CONCLUSIONS： Both adenoid hypertrophy and maxillary sinus mucosal thickening have impact on dentofacial development. Moderate or more severe adenoid hypertrophy with maxillary sinus mucosal thickening has greater impact on dentofacial development over adenoid hypertrophy or maxillary sinus mucosal thickening alone.

Clinical effect of mometasone furoate nasal spray combined with montelukast in the treatment of children with obstructive sleep apnea hypopnea syndrome

Objective To explore the clinical effect of mometasone furoate nasal spray combined with montelukast in the treatment of children with obstructive sleep apnea hypopnea syndrome (OSAHS), and to analyze its feasibility and clinical application value. Methods From August 2017 to March 2019, 64 children with OSAHS who were treated in the People's Hospital of Jinhua were selected in the study.According to the random number table method, they were divided into the observation group and the control group, with 32 cases in each group.The observation group was treated with mometasone furoate nasal spray combined with montelukast for 12 weeks.The control group was treated with surgical treatment to remove hypertrophic tonsils and/or adenoids.The clinical symptom scores, polysomnography(PSG) monitoring index, adenoid and tonsil size index, and the efficacy after 12 weeks of treatment were compared between the two groups. Results There were no statistically significant differences in symptom scores and minimum arterial oxygen saturation(LSaO2) between the two groups before treatment(all P>0.05). After treatment, the symptom scores and LSaO2 of the control group were (1.90±0.53)points and (94.74±1.54)%, respectively, which of the observation group were (4.00±1.50)points and (85.34±10.57)%, respectively, the differences between the two groups were statistically significant(t=-7.416, 4.972, all P<0.05). There were statistically significant differences in the apnea hypopnea index(AHI) and obstructive apnea index(OAI) between the two groups(all P<0.05). After treatment, the A/N of the adenoids in the observation group was significantly decreased, and the difference in the tonsil classification was statistically significant(Z=-2.602, P<0.05). The effective rate of the observation group was 56.25%(18/32), which was significantly lower than that of the control group [100.00%(32/32)], the difference was statistically significant(χ2=17.920, P<0.05). Conclusion In summary, non-surgical treatment can alleviate OSAHS-related symptoms, reduce the size of tonsils and adenoids, and achieve the purpose of remission or cure.Non-surgical treatment can be selected when patients' families are reluctant to choose surgical treatment. Key words: Sleep apnea, obstructive; Glucocorticoids; Leukotriene antagonists; Tonsillectomy; Adenoidectomy; Polysomnography; Blood gas monitoring, transcutaneous; Ventilation-perfusion ratio; Children

Clinical application of exhaled nitric oxide in children with upper airway diseases

The exhaled air of healthy people contains nitric oxide.Under the physiological condition, nasal nitric oxide(NNO) comes primarily from the sinuses, a little is produced in the nasal mucosa.Fractional exhaled nitric oxide is mainly from the trachea and bronchus.When airway diseases occur, it can influence the concentration of exhaled nitric oxide.Therefore, with the continuous improvement of technology in recent years, the measurement of NNO has been widely used in upper airway diseases of children.It is characteristics of quantitative, non-invasive, simple and safe.This article reviews the measurement methods of NNO and its clinical application in children upper airway diseases such as rhinitis, sinusitis, nasal polyps and adenoid hypertrophy. Key words: Exhaled nitric oxide; Upper airway disease; Child

Solid variant of adenoid cystic carcinoma with basaloid features in trachea: report of a case

肺原发性腺样囊性癌是一类与唾液腺相应名称肿瘤组织学形态一致的恶性上皮性肿瘤，主要发生于气管及主支气管。肿瘤组织主要有3种类型：筛状型、管状型和实体型。具有基底细胞样特征的实体型腺样囊性癌是其中一种罕见亚型，肿瘤细胞形成大小不一的实性结构，与经典型相比，实体型更具侵袭性，易发生转移，预后差。该文报道1例31岁男性患者发生于气管的实体型腺样囊性癌，分析其临床病理学特征、免疫表型特点及鉴别诊断，旨在提高对该病的认识，提高临床诊治水平。

Pathologic analysis of 83 cases with orbit neoplasm

Objective To analyze pathological types of orbit neoplasm. Methods The clinical data of 83 cases of orbit neoplasm from Mar. 1996 to Dec. 2013 were retrospectively analyzed. All cases received exenteration of orbit. Results There were 65 cases (78.3%) of malignant tumor. The most frequent malignant tumors were adenoid cystic carcinoma 19 cases (22.9%), rhabdomyosarcoma 13 cases (15.7%), malignant melanoma 8 cases (9.7%), retinoblastoma 7 cases (8.4%), etc. The 18 benign tumors included meningioma 8 cases (9.7%), inflammatory pseudotumor 5 cases (6.0%), etc. Conclusion The exenteration of orbit is mainly for the treatment of orbital malignant tumors, some orbital benign tumors and external tumors invading the orbit. According to the nature, location and extent of the tumor, reasonable selection of surgical methods and adjuvant treatments can achieve better results. Key words: Orbit exenteration; Orbit neoplasms; Pathology

(18)F-fluorodeoxy glucose positron emission tomography/computed tomography manifestation and clinical characteristics of primary salivary gland-type lung cancer

Objective: To explore the imaging manifestation and clinical characteristics of primary salivary gland-type lung cancer using (18)F-fluorodeoxy glucose ((18)F-FDG) positron emission tomography/computed tomography (PET-CT). Methods: From March 2009 to January 2017, 12 patients with pathologically confirmed primary salivary gland-type lung cancer were enrolled in First Affiliated Hospital of Nanjing Medical University. Their images and clinicopathological data were retrospectively analyzed. Results: Six out of 12 patients had mucoepidermoid carcinoma (MEC), and the other six patients had adenoid cystic carcinoma (ACC). Five MEC were located in the main bronchus, and the other one was in segmental bronchus. Intrabronchial nodule or mass with smooth or lobulated margin and calcification(n=3) was the main (18)F-FDG PET-CT features of MEC. Two ACC involved trachea, two involved the main bronchi, and the other two involved lobular bronchi. The main (18)F-FDG PET-CT features of ACC were diffuse or circumferential irregular thickness of the bronchial wall, distorted lumen, and the longitudinal extent of the tumor was greater than its transverse axis. The (18)F-FDG uptake of all lesions was increased in varying degree. The median (25th percentile, 75th percentile) value of maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were 5.1(3.1, 8.1), 5.7(1.2, 21.4)cm(3) and 18.6(0.6, 93.7), respectively. All of them were related to pathological grading and nodal tumor involvement( all P<0.05), but not associated with tumor location or pathological type( all P>0.05). MTV and TLG were also related to clinical stage( all P<0.05). Tumor size was correlated with MTV, TLG of primary lesions(r=0.607, P=0.036; r=0.579, P=0.049), but not with SUVmax(r=0.568, P=0.054). Conclusions: Primary salivary gland-type lung cancer mainly occurs in segmental bronchus. The MTV and TLG of the tumor calculated by (18)F-FDG PET-CT are correlated with clinicopathological characteristics, and are helpful for clinical diagnosis and treatment.

Clinicopathological analysis of 22 cases with primary malignant tumors of the lacrimal sac

Objective To analyze the clinicopathological features sac of primary malignant tumors of lacrimal. Methods The clinical and pathologic data of 22 eyes of 22 patients with primary malignant tumors from lacrimal sac of Jan. 2014 to Dec. 2017 were analyzed retrospectively. Results All cases received pathological examination of tumors after surgical excision. Among 12 cases(54.50%) of epithelial malignant tumor: there were squamous cell carcinoma in 5 cases(41.70%), inverted papilloma with malignant transformation in 2 cases(16.70%), undifferentiated carcinoma in 2 cases(16.70%), basal cell carcinoma in 1 case(8.33%), adenocarcinoma in 1 case(8.33%) and adenoid cystic carcinoma in 1 case(8.33%). Among 10 cases(45.50%)with nonepithelial malignant tumors: there were B-cell lymphoma of mucosa-associated lymphoid tissue in 5 cases(50.00%), malignant melanoma in 3 cases(30.00%), lacrimal sac leiomyosarcoma in 1 case(10.00%) and dermatofibrosarcoma protuberans in 1 case(10.00%). Conclusion Most malignant lacrimal tumors are squamous cell carcinoma, B-cell lymphoma of mucosa-associated lymphoid tissue and malignant melanoma. Key words: Lacrimal apparatus diseases; Carcinoma, squamous cell; Carcinoma, basal cell; Lymphoma mucosa-associated lymphoid tissue

Polymorphous adenocarcinoma: an overview of immunohistochemical features and insights on molecular pathology.

Polymorphous adenocarcinoma (PAC), represents a common minor salivary gland tumor (SGT) characterized by local growth, low metastatic potential and non-aggressive biologic behavior. Due to the clinical aggressiveness noted in a subset of such tumors, the former term polymorphous low-grade adenocarcinoma (PLGA) was recently revised. PAC's clinical features and histological diversity result in clinical overlap of this entity with several other SGTs including mainly adenoid cystic carcinoma (AdCC). Differential diagnosis among the entities is crucial, in terms of tumor management and patients' prognosis. The aim of the present review is to summarize the histological, cytological, immunohistochemical and molecular features of PAC. Histopathological examination is usually adequate for PAC differential diagnosis from other SGTs, except of AdCC. Several immunohistochemical markers including c-Kit, S-100/ MG, Mcm-2 and Integrin β-1, -3, -4, are reported to be useful diagnostic aids in borderline cases. Limitations in sample numbers and study methodology issues of the immunohistochemical PAC studies complicate the identification and selection of appropriate markers useful in the differential diagnosis. Additionally, molecular analyses of PAC specimens indicate that the PAC spectrum phenotypes result from different genotypes (protein kinase D positive; PRKD(+) and PRKD(-) tumors). PAC pathogenesis remains to be determined in each particular genotype while the convergence issue should be addressed in future studies.

Adenoid cystic carcinoma in pterygopalatine fossa misdiagnosed as temporomandibular joint arthritis: report of one case and review of literature

目的 探讨腺样囊性癌的临床病理特征、诊断和治疗，以避免误诊误治。 方法 回顾性分析青岛大学附属威海市立第二医院收治的1例翼腭窝腺样囊性癌误诊为颞下颌关节炎患者的临床资料，并复习相关文献。 结果 该患者行鼻内窥镜下右侧翼腭窝间隙探查后病理确诊为腺样囊性癌，在内窥镜辅助下切除肿瘤，术后随访1年，无复发。 结论 腺样囊性癌为多见于小涎腺的恶性肿瘤，少数可发生于腺体外，早期症状不典型，易漏诊、误诊。其确诊主要依靠组织病理学检查，治疗首选手术及术后放疗。

PFKFB3促进腺样囊性癌ACC-2细胞增殖、迁移、侵袭和转移

Objective To evaluate the expression of 6-phosphofructo-2-kinase/fructose-2, 6-bisphosphatase 3 (PFKFB3) in adenoid cystic carcinoma and the effects of PFKFB3 on the proliferation, migration, invasion and tumorigenesis in vivo of adenoid cystic carcinoma cells. Methods Immunohistochemistry and Western blotting were applied to detect the expression of PFKFB3 in 29 cases of adenoid cystic carcinoma tissues and 10 cases of para-carcinoma normal salivary gland tissues. PFKFB3 in adenoid cystic carcinoma ACC-2 cells was silenced by adenovirus vector. The effects of PFKFB3 silence on cell proliferation, migration, invasion and tumorigenesis in vivo and distant metastasis of adenoid cystic carcinoma cells were evaluated by cell proliferation assay, wound healing assay, Transwell assay, xenografted mice model and lung metastasis mice model. Results The results of immunohistochemical staining showed that the positive expression rate of PFKFB3 in adenoid cystic carcinoma tissues was 93.1% (27/29), and the positive expression rate of PFKFB3 in normal salivary gland tissues was 20.0% (2/10), with a significant difference (χ2=20.84, P<0.001). The results of methyl thiazolyl tetrazolium (MTT) assay showed that, compared with ACC-2 group, the proliferation activity of cancer cells with silence of PFKFB3 (PFKFB3--ACC-2) was significantly suppressed for 72 h (1.8±0.2 vs. 4.7±0.8, t=3.582, P=0.001). The results of wound healing assay showed that after scraping cells away for 24 h, the number of cells in the scratch area was 99.8±13.2 in the PFKFB3--ACC-2 group, which was significantly less than that in the ACC-2 group (263.0±97.4, t=2.868, P=0.029). Transwell results indicated that the number of cells passing through matrigel was 17.6±2.1 in the PFKFB3--ACC-2 group, which was less than that in the ACC-2 group (28.6±3.8, t=4.452, P=0.004). The tumor volume in the PFKFB3--ACC-2 [(623.5±134.1) mm3] was smaller than that in the ACC-2 group [(1 621.0±278.1) mm3,t=4.213, P=0.001]. More pulmonary metastases were found in the ACC-2 group than PFKFB3--ACC-2 group (18.1±3.2 vs. 4.1±2.2, t=6.322, P=0.001). Conclusion The expression of PFKFB3 is higher in adenoid cystic carcinoma tissue than normal salivary gland tissue, and the highly expressed PFKFB3 plays a driving role in the proliferation, migration, invasion and metastasis in adenoid cystic carcinoma. Key words: Carcinoma, adenoid cystic; Glycolysis; PFKFB3; Tumor development

The imaging features and prognosis of primary central airway salivary gland-type tumor

Objective To analyze the image features and prognosis of primary central airway salivary gland-type tumor (SGT). Methods The clinical and imaging data of 25 cases with SGT confirmed by histopathology were retrospectively analyzed in our hospital from October 2009 to November 2017. Follow up of patients for survival was performed. Among 25 cases of SGT, there were 14 cases of adenoid cystic carcinoma (ACC), ten cases of mucoepidermoid carcinoma (MEC) and one case of mucoepidermoid carcinoma (EMC). All cases had non-enhanced CT scans (among which 20 cases underwent CT scan with contrast). Post-processing were performed to evaluate the location, range, density, degree of enhancement of the lesions and involvement of hilar or mediastinal lymph nodes. Eight cases underwent PET/CT imaging and one underwent MR imaging, respectively. Independent sample t test was used to compare difference in ages between ACC group and MEC group. Nonparametric test was performed to compare difference in tumor′s diameter between ACC group and MEC group. Comparison of genders, history of smoking, tumor-node-metastasis (TNM) stage and CT features between ACC group and MEC group were tested using Fisher′s exact tests. Survival was calculated using the Kaplan-Meier method, and the survival curves were compared by the log-rank test. Results Compared to MEC, patients with ACC were older. There were significant difference between the two groups (t=3.154, P<0.05). ACC tended to involved trachea or main bronchi (13/14) while MEC were mostly located at lobar or segment bronchi (6/10). The shape of ACC tumors were mainly lobulated or presented as circumferential wall thickening (13/14), while MECs were smoothly oval (7/10). On contrast-enhanced CT scans, ACC mainly showed mild or moderate enhancement (9/10), While most of MEC had shown avid enhancement (8/10). CT findings suggestive of airway obstructive disease were seen more with MEC (9/10) than ACC (4/14). There were significant differences of the above CT features between ACC and MEC group (P<0.05). A case of EMC in an 43 years old female presented rounded nodule in tracheal; The SUVmax in 6 of 8 cases of PET/CT exceeded 2.2; Overall survival (OS) was 87.5% in all cases. No significant difference was found between ACC and MEC groups regarding OS (χ2=0, P=1.000). Ages, surgical and nonsurgical patients and TNM stage were found to be related to OS (χ2=13.799, 13.799, 13.171, respectively, P<0.05). Conclusions Primary central airway salivary gland-type tumors are commonly occurred in patients at a low age, with weak invasive feature and good prognosis. The predominant site and CT characteristics between ACC and MEC were significantly different. Key words: Salivary gland neoplasms; Tomography, X-ray computed; Magnetic resonance imaging; Prognosis

Adenoid cystic carcinoma of Bartholin’s gland. From the ISSVD Case Consultation Committee

Adenoid cystic carcinoma of Bartholin’s gland. From the ISSVD Case Consultation Committee

Dynamics of nasopharyngeal colonisation & correlations with lymphocyte populations in the adenoid & peripheral blood of chronic otitis media prone children

Dynamics of nasopharyngeal colonisation & correlations with lymphocyte populations in the adenoid & peripheral blood of chronic otitis media prone children

Adenoid cystic carcinoma in trachea or bronchus: clinicopathological analysis of four cases

目的 探讨气管、支气管腺样囊性癌（ACC）患者的临床病理特征、免疫表型、诊断、鉴别诊断、治疗及预后。 方法 以2009年4月至2014年2月江苏省泰州市人民医院收治的4例气管、支气管ACC患者为研究对象，对其临床表现、影像学特征、组织学形态及免疫表型进行观察和分析，并复习相关文献。 结果 男性2例，女性2例；年龄23~65岁。主要临床症状为咳嗽、气喘、咳痰伴痰血。肿瘤发生于气管或主支气管，患者胸部CT检查示气管或支气管壁不规则增厚或软组织密度影，边界欠清。光学显微镜下见癌组织浸润性生长，结构以管状、筛孔状为主，部分区域呈实性，癌细胞大小、形态比较一致，核质比高，核深染。免疫组织化学示癌细胞CK7、p63、SMA、calponin、CD117均阳性。2例患者行手术治疗，手术切缘均有癌残留，其中1例接受了术后放疗，随访3年无复发转移。2例患者仅接受了姑息性放化疗，分别于治疗27个月和28个月出现复发及转移。 结论 气管、支气管ACC是一种罕见的低度恶性肿瘤，临床症状不典型，其诊断及鉴别诊断主要依据病理形态学特征及免疫表型。