Basaloid squamous cell carcinoma of floor of mouth

BACKGROUND

Only five cases of basaloid squamous cell carcinoma (BSCC), a rare tumor of head and neck, have been reported to involve the floor of mouth.

METHODS

Clinicopathologic and immunohistochemical features of eight BSCC of floor of mouth were studied to evaluate the significance of the basaloid features.

RESULTS

Five patients were male and three were female. Their mean age was 52 years (range, 39-59). At presentation, one patient was diagnosed with Stage II disease, four were diagnosed with Stage III disease, and three were diagnosed with Stage IV disease. Aside from typical squamous differentiation, each patient had a component of basaloid cells arranged in irregular nests, cords, or pseudoglandular spaces with a brisk mitotic rate, myxoid stroma, and marked tendency for perineural invasion. A panel of immunostains yielded the following results: keratin, +8/8; carcinoembryonic antigen, +3/8; and S-100, chromogranin, and neuron-specific enolase were negative. Mucin stains were negative in all cases. Ultrastructural characterization of three BSCC revealed squamous differentiation of the basaloid cells and a peculiar basal membrane-like material in between them. No neurosecretory granules were present. Seven patients underwent surgery; six of them were also treated with postoperative radiation therapy. In two cases, chemotherapy was added at recurrence. One nonresectable patient received radiation and chemotherapy. At the last follow-up, five patients were dead of disease within 13 months from the diagnosis. One patient died of an unknown cause. Two patients were still alive at the time of this report, 4 and 2 months after treatment. Seven patients had recurrent disease. The authors compared these data with a control group of patients with conventional squamous cell carcinoma (SCC).

CONCLUSIONS

The authors' results indicate that BSCC of floor of mouth is an aggressive variant of SCC and is prognostically worse than the conventional SCC, regardless of the grade of the latter.

[Effects of immunomodulation on antineoplastic radiotherapy. A controlled clinical study]

It is well known that thymic hormones can counteract immunodepression due to radiation therapy, preventing and reducing the severity and the number of myelotoxic and hematologic reactions. We tried to confirm these findings in a controlled multicenter clinical study involving 1,060 patients undergoing radiation therapy (580 treated with thymopentin 50 mg s.c. every other day, after irradiation and for at least 6 cycles of 4 weeks each, and 480 control patients). Highly statistically significant results (to the ANOVA test) were obtained in the protection against radiation-induced leukopenia in the treated group; furthermore, the treated patients had a marked reduction (p = 0.003 chi 2 test) in the early delayed reactions to irradiation, namely in the upper aero-digestive tract. In general, we observed a better, but not statistically significant recovery of the blood parameters, lymphocyte subsets and skin tests in the treated group versus the control group. Both of the treated groups showed the same trend for Karnofsky performance status and body weight. The local and general protection provided by thymopentin against the reactions to irradiation could be advantageously used for the administration of higher doses of radiation therapy.

Spermatocyte chromosome analysis of Helicella virgata (Pulmonata: Helicidae): silver-stained and C-banded chromosomes

Chromosome numbers of the snail Helicella virgata from the fields of Castellammare del Golfo (Sicily) are n = 26 and 2n = 52. Silver-staining analyses of testicular cells suggest that both mitotic and meiotic chromosomes are involved in nucleolus organization. A within-individual variability in NOR-banding pattern is present in each of the 20 specimens analyzed.

The effect of tension on muscle flaps

An experiment with an animal model was designed to investigate whether an arterialized and innervated muscle flap has an optimal tension when being inset. Arterialized pedicle muscle flap operations using various tensions at the time of insetting were performed on beagles. At three months no acute, recent, or chronic changes were noted in the muscle fiber or in the surrounding connective tissue when biopsy samples were examined microscopically. We conclude that the tension of a pedicle muscle flap makes no difference in its long-term compliance or morphology.

Karyological studies in Coris julis (Pisces, Labridae)

In the present investigation the diploid number 2n = 48 (NF = 58) has been determined for females, primary males, and secondary males of Coris julis from the Gulf of Palermo. Differentiated sex chromosomes have not been observed in the population under study.

CHROMOSOME POLYMORPHISM IN GOBIUS PAGANELLUS, LINNEO 1758 (PISCES, GOBIIDAE)

In the present investigation the diploid numbers 2n = 45, 2n = 46, 2n = 47, and 2n = 48 have been determined for Gobius paganellus. Specimens of different sex were found to have exactly the same karyotype. This species is characterized by two fundamental numbers: NF = 47, and NF = 48. Chromosome polymorphism due to different chromosome rearrangements within the A-type complement is present in this species.

THE KARYOLOGY OF TEREDO UTRICULUS (GMELIN) (MOLLUSCA, PELECYPODA)

By counting spermatocyte and oocyte bivalents and mitotic metaphase chromosomes in cleaving eggs, we have determined both the haploid (n = 19) and the diploid numbers (2n = 38) respectively, for the species Teredo utriculus. An XY and XO sex-determining mechanism is absent in the species under study. chromosomes cannot be grouped into different classes according to length. It seems that, for Teredo utriculus, a high number of chromosomes is not necessarily accompanied by a high amount of chromosomal DNA.

Alpha-1-antitrypsin deficiency--a cause of cryptogenic liver disease in the elderly

We report a 73-year-old woman with homozygous ZZ alpha-1-antitrypsin deficiency (AATD), micronodular cirrhosis, cholestatic jaundice, and emphysema. An elevated SGOT/SGPT ratio was noted in the absence of chronic alcoholism. ERCP demonstrated a normal extrahepatic biliary system and suggested obstruction of the intrahepatic ducts. An operative liver biopsy demonstrated periodic acid-Schiff-positive, diastase resistant intracytoplasmic inclusion bodies. This patient reminds us that metabolic causes of cryptogenic liver disease need to be considered, even in the elderly. We review briefly the literature concerning AATD and liver disease.

Stromal reaction to neoplasia: colonic carcinomas

The stroma and stromal reaction in the normal colon and in 14 different colonic tumors were studied by electron microscopy. Elastosis is a significant part of the stromal reaction to colonic adenocarcinomas and rectal squamous cell carcinomas. Two carcinoid tumors elicited no significant elastosis. In some of the adenocarcinomas, small muscular arteries close to neoplastic tissue developed massive elastosis of the media. This may indicate that the elastosis is due to stimulation of nonneoplastic stromal cells by some unknown neoplastic factor or factors.

Myelolipoma in a heterotopic adrenal gland: light and electron microscopic findings

A symptomatic myelolipoma of the heterotopic adrenal gland was diagnosed as the cause of nephrotic syndrome and was surgically removed. Remission of the nephrotic syndrome promptly ensued. Ultrastructurally, the tumor consisted of well-differentiated cells resembling adrenal cortical cells, bone marrow cells in various stages of differentiation, and lipid cells. Some cells that contained fat were of adrenal cortical origin, but the derivation of most lipid cells and of bone marrow elements could not be deduced from the present ultrastructural findings.

Metastatic ductal carcinoma of the parotid gland in a patient with sarcoidosis

A 38-year-old man with a history of sarcoidosis and ductal carcinoma of the parotid had metastasis to the pleura and skin. This skin metastasis resembled carcinoma of the breast. There is a possibility of sarcoidosis with its depressed cellular immunity predisposing to malignancy.