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Priya NS. Lymph nodes in health and disease - A pathologist's perspective. J Oral Maxillofac Pathol 2023; 27:6-11. [PMID: 37234324 PMCID: PMC10207202 DOI: 10.4103/jomfp.jomfp_40_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 02/21/2023] [Indexed: 05/27/2023] Open
Abstract
A lymph node (LN) being a unique immunological organ has the ability to adapt when exposed to emigrants. The structural and architectural components are tampered, and it acts as an efficient immune checker in the presence of an antigen and also exhibits a morphological drift when neoplastic cells evade the organ. So, understanding the basics of histology of a lymph node is essential for the better identification and interpretation of pathological events occurring in a lymph node. A phenomenon pertaining to LNs, interpretation of reactive and neoplastic lymph nodes at morphological levels and pathological diversity of LNs in selected disease processes are emphasised.
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Affiliation(s)
- N S Priya
- Department of Oral and Maxillofacial Pathology, V. S. Dental College and Hospital, Bengaluru, Karnataka, India
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Abstract
Salivary gland diseases are rare. In the European Union (EU) a disease is considered to be rare if not more than 5 of 10,000 people are affected by it. According to estimates in Germany are about 4 million people with a rare disease. In the EU are about 30 million people with rare diseases [1]. In the present work most of the described diseases of salivary glands and of the facial nerve fall in this category. They form a very heterogeneous group whose treatment takes place mainly in specialized centers. Still, it is essential for the otolaryngologist to identify and to diagnose these diseases in order to initiate the right therapeutic steps. The work is a compilation of innate andacquired rare salivary gland disorders and of rare facial nerve disorders. The etiologies of inflammatory diseases, autoimmune disorders and tumors are taken into account. For the individual topics, the current literature, if available, was evaluated and turned into summarized facts. In this context the development of new processes, diagnostics, imaging and therapy are considered. Genetic backgrounds of salivary gland tumors and the trends in the treatment of tumorous lesions of the facial nerve are picked up. Furthermore, also rare diseases of the salivary glands in childhood are described. Some of them can occur in adults as well, but differ in frequency and symptoms. Due to the rarity of these diseases, it is recommended to tread these in centers with special expertise for it. Finally, the difficulties of initiation of studies and the problems of establishing disease registries concerning salivary gland disorders are discussed. This is very relevant because these pathologies are comparatively seldom.
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Affiliation(s)
- Claudia Scherl
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie,
Universitätsklinikum Mannheim
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Oral lymphoid lesions: a 47-year clinicopathological study in a Brazilian population. Med Mol Morphol 2018; 52:123-134. [PMID: 30382358 DOI: 10.1007/s00795-018-0210-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 10/25/2018] [Indexed: 01/25/2023]
Abstract
We performed an epidemiological, clinical and histopathological analysis of oral lymphoid lesions (OLLs) during a 47-year period. Data regarding patient age, sex, duration, location, symptomatology, type of growth, implantation, staining, presence of ulceration and bleeding of all cases were compiled from the clinical data. For the histopathological analyses, all slides stained by H/E were reassessed. During the analyzed period, 14,565 patients with oral and maxillofacial lesions were diagnosed, with 45 cases diagnosed as OLLs. The most prevalent location was the tongue. Females were more affected, and the mean age was 40.8 years. OLLs presented a heterogeneous frequency, with the prevalence of reactive lesions (42.3%) followed by developmental lesions (35.6%). Among the reactive lesions, foreign body granulomas were the most common. Regarding diagnosed neoplasms, malignant represented 13.2% of the cases. The average time of evolution of OLLs in general was of 22.2 months. Regarding the histopathological characteristics, the presence of primary lymphoid follicles was observed in 37.8% of the cases, while inflammatory infiltrates were diffuse in 66.7% and epimyoepithelial islands were observed in 13.3%. Our study concludes that OLLs involves a broad spectrum of lesions that share the presence of the lymphoid component, which can range from indolent to more aggressive behavior.
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Inarejos Clemente EJ, Navallas M, Tolend M, Suñol Capella M, Rubio-Palau J, Albert Cazalla A, Rebollo Polo M. Imaging Evaluation of Pediatric Parotid Gland Abnormalities. Radiographics 2018; 38:1552-1575. [DOI: 10.1148/rg.2018170011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Emilio J. Inarejos Clemente
- From the Departments of Diagnostic Imaging (E.J.I.C., M.N., M.R.P.), Pathology (M.S.C.), and Maxillary and Oral Surgery (J.R.P., A.A.C.), Hospital Sant Joan de Deu, Av. Sant Joan de Deu 2, CP 08950 Esplugues de Llobregat (Barcelona), Spain; and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada (M.T.)
| | - María Navallas
- From the Departments of Diagnostic Imaging (E.J.I.C., M.N., M.R.P.), Pathology (M.S.C.), and Maxillary and Oral Surgery (J.R.P., A.A.C.), Hospital Sant Joan de Deu, Av. Sant Joan de Deu 2, CP 08950 Esplugues de Llobregat (Barcelona), Spain; and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada (M.T.)
| | - Mirkamal Tolend
- From the Departments of Diagnostic Imaging (E.J.I.C., M.N., M.R.P.), Pathology (M.S.C.), and Maxillary and Oral Surgery (J.R.P., A.A.C.), Hospital Sant Joan de Deu, Av. Sant Joan de Deu 2, CP 08950 Esplugues de Llobregat (Barcelona), Spain; and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada (M.T.)
| | - Mariona Suñol Capella
- From the Departments of Diagnostic Imaging (E.J.I.C., M.N., M.R.P.), Pathology (M.S.C.), and Maxillary and Oral Surgery (J.R.P., A.A.C.), Hospital Sant Joan de Deu, Av. Sant Joan de Deu 2, CP 08950 Esplugues de Llobregat (Barcelona), Spain; and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada (M.T.)
| | - Josep Rubio-Palau
- From the Departments of Diagnostic Imaging (E.J.I.C., M.N., M.R.P.), Pathology (M.S.C.), and Maxillary and Oral Surgery (J.R.P., A.A.C.), Hospital Sant Joan de Deu, Av. Sant Joan de Deu 2, CP 08950 Esplugues de Llobregat (Barcelona), Spain; and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada (M.T.)
| | - Asteria Albert Cazalla
- From the Departments of Diagnostic Imaging (E.J.I.C., M.N., M.R.P.), Pathology (M.S.C.), and Maxillary and Oral Surgery (J.R.P., A.A.C.), Hospital Sant Joan de Deu, Av. Sant Joan de Deu 2, CP 08950 Esplugues de Llobregat (Barcelona), Spain; and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada (M.T.)
| | - Monica Rebollo Polo
- From the Departments of Diagnostic Imaging (E.J.I.C., M.N., M.R.P.), Pathology (M.S.C.), and Maxillary and Oral Surgery (J.R.P., A.A.C.), Hospital Sant Joan de Deu, Av. Sant Joan de Deu 2, CP 08950 Esplugues de Llobregat (Barcelona), Spain; and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada (M.T.)
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Oishi N, Bagán JV, Javier K, Zapater E. Head and Neck Lymphomas in HIV Patients: a Clinical Perspective. Int Arch Otorhinolaryngol 2017; 21:399-407. [PMID: 29018505 PMCID: PMC5629092 DOI: 10.1055/s-0036-1597825] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 10/31/2016] [Indexed: 12/13/2022] Open
Abstract
Introduction Because of the many HIV-related malignancies, the diagnosis and treatment of lymphoma in patients infected with human immunodeficiency virus are challenging. Objective Here, we review current knowledge of the pathogenesis, epidemiology, symptomatology, diagnosis, and treatment of head and neck lymphomas in HIV patients from a clinical perspective. Data Synthesis Although Hodgkin's lymphoma is not an AIDS-defining neoplasm, its prevalence is ten times higher in HIV patients than in the general population. NHL is the second most common malignancy in HIV patients, after Kaposi's sarcoma. In this group of patients, NHL is characterized by rapid progression, frequent extranodal involvement, and a poor outcome. HIV-related salivary gland disease is a benign condition that shares some features with lymphomas and is considered in their differential diagnosis. Conclusion The otolaryngologist may be the first clinician to diagnose head and neck lymphomas. The increasing survival of HIV patients implies clinical and epidemiological changes in the behavior of this disease. Early diagnosis is important to improve the prognosis and avoid the propagation of HIV infection.
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Affiliation(s)
- Natsuki Oishi
- ENT Department, Consorci Hospital General Universitari de Valencia, Valencia, Spain
- ENT Department, Universitat de Valencia Facultat de Medicina i Odontologia, Valencia, Comunitat Valenciana, Spain
| | - José Vicente Bagán
- Department of Stomatology, Consorci Hospital General Universitari de Valencia, Valencia, Comunitat Valenciana, Spain
| | - Karla Javier
- Department of Haematology, Consorci Hospital General Universitari de Valencia, Valencia, Comunitat Valenciana, Spain
| | - Enrique Zapater
- ENT Department, Consorci Hospital General Universitari de Valencia, Valencia, Spain
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Ogasawara N, Takano KI, Kobayashi H, Kikuchi K, Matsumiya H, Yoshioka I, Himi T. HIV-associated cystic lesions of the parotid gland. Auris Nasus Larynx 2016; 44:126-130. [PMID: 27264875 DOI: 10.1016/j.anl.2016.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 04/26/2016] [Accepted: 05/13/2016] [Indexed: 11/30/2022]
Abstract
We present two cases of an HIV-associated parotid gland cyst. One case was a 36-year-old HIV infected woman. She was diagnosed with HIV infection and presented with slowly enlarged parotid gland cysts together with elevation of HIV viral RNA copies/mL in her serum. She was performed parotid gland biopsy under the general anesthesia. The histopathologic analysis revealed negative HIV p24-antigen in her parotid gland tissue. The other case was a 43-year-old man found his parotid gland swelling shortly after highly active antiretroviral therapy (HAART). He was diagnosed with HIV infection 2 years previously. He had started HAART several days before. He showed exceeding elevation of IgE in his serum. We treated him with medication using anti-histamic drugs for his cyst. A computed tomography scan revealed a complete response of his parotid gland cyst 4 weeks after the medication. His serum IgE level was decreased to half of the level before the medication. These findings suggested that the parotid gland swelling associated with HIV was due to various factors including immune reconstitution inflammatory syndrome (IRIS). In case such a parotid gland swelling, we could avoid invasive treatments.
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Affiliation(s)
- Noriko Ogasawara
- Department of Otorhinolaryngology, Sapporo Medical University School of Medicine, Sapporo, Japan; Department of Otorhinolaryngology, Obihiro Kousei Hospital, Japan.
| | - Ken-Ichi Takano
- Department of Otorhinolaryngology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | | | | | - Hiroshi Matsumiya
- Department of Otorhinolaryngology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Iwao Yoshioka
- Department of Otorhinolaryngology, Obihiro Kousei Hospital, Japan
| | - Tetsuo Himi
- Department of Otorhinolaryngology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Burger-Calderon R, Webster-Cyriaque J. Human BK Polyomavirus-The Potential for Head and Neck Malignancy and Disease. Cancers (Basel) 2015; 7:1244-70. [PMID: 26184314 PMCID: PMC4586768 DOI: 10.3390/cancers7030835] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 06/25/2015] [Accepted: 06/25/2015] [Indexed: 12/22/2022] Open
Abstract
Members of the human Polyomaviridae family are ubiquitous and pathogenic among immune-compromised individuals. While only Merkel cell polyomavirus (MCPyV) has conclusively been linked to human cancer, all members of the polyomavirus (PyV) family encode the oncoprotein T antigen and may be potentially carcinogenic. Studies focusing on PyV pathogenesis in humans have become more abundant as the number of PyV family members and the list of associated diseases has expanded. BK polyomavirus (BKPyV) in particular has emerged as a new opportunistic pathogen among HIV positive individuals, carrying harmful implications. Increasing evidence links BKPyV to HIV-associated salivary gland disease (HIVSGD). HIVSGD is associated with elevated risk of lymphoma formation and its prevalence has increased among HIV/AIDS patients. Determining the relationship between BKPyV, disease and tumorigenesis among immunosuppressed individuals is necessary and will allow for expanding effective anti-viral treatment and prevention options in the future.
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Affiliation(s)
- Raquel Burger-Calderon
- Microbiology and Immunology Department, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Jennifer Webster-Cyriaque
- Microbiology and Immunology Department, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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Wu B, Ngo R, Petersson F. Cystic lymphoid hyperplasia of the parotid gland as the initial manifestation of HIV infection. Singapore Med J 2015; 55:e12-6. [PMID: 24452982 DOI: 10.11622/smedj.2014010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We report the case of a patient who presented with cystic lymphoid hyperplasia of the right parotid gland as the index diagnosis of HIV infection. Histological examination of the excised parotid gland revealed a solid-cystic lymphoepithelial lesion with a non-keratinous squamous epithelium, which grew into the lymphoid component via anastomosing cords and islands. These anastomosing cords and islands contained variably abundant B cells, several subepithelial multinucleated histiocytes, salivary ducts infiltrated by small lymphocytes, and a dense lymphoid infiltrate containing lymphoid follicles with enlarged, irregular germinal centres.
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Affiliation(s)
- Bingcheng Wu
- Department of Pathology, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074.
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Fu X, Guo L, Lv K, Wang L, Ran W, Tan Q, Wang J, Liu X. Sonographic appearance of cervical lymphadenopathy due to infectious mononucleosis in children and young adults. Clin Radiol 2014; 69:239-45. [DOI: 10.1016/j.crad.2013.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 07/20/2013] [Accepted: 09/18/2013] [Indexed: 10/26/2022]
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López-Muñoz F, Sim K, Shen WW, Huelves L, Moreno R, Molina JDD, Rubio G, Noriega C, Pérez-Nieto MÁ, Alamo C. A bibliometric study of scientific research conducted on second-generation antipsychotic drugs in Singapore. Singapore Med J 2014; 55:24-33. [PMID: 24452974 PMCID: PMC4291907 DOI: 10.11622/smedj.2014006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION A bibliometric study was carried out to ascertain the volume and impact of scientific literature published on second-generation antipsychotic drugs (SGAs) in Singapore from 1997 to 2011. METHODS A search of the EMBASE and MEDLINE databases was performed to identify articles originating from Singapore that included the descriptors 'atypic* antipsychotic*', 'second-generation antipsychotic*', 'clozapine', 'risperidone', 'olanzapine', 'ziprasidone', 'quetiapine', 'sertindole', 'aripiprazole', 'paliperidone', 'amisulpride', 'zotepine', 'asenapine', 'iloperidone', 'lurasidone', 'perospirone' and 'blonanserin' in the article titles. Certain bibliometric indicators of production and dispersion (e.g. Price's Law on the increase of scientific literature, and Bradford's Law) were applied, and the participation index of various countries was calculated. The bibliometric data was also correlated with some social and health data from Singapore, such as the total per capita expenditure on health and gross domestic expenditure on research and development. RESULTS From 1997 to 2011, a total of 51 articles on SGAs in Singapore were published. Our results suggested non-fulfilment of Price's Law (r = 0.0648 after exponential adjustment vs. r = 0.2140 after linear adjustment). The most widely studied drugs were clozapine (21 articles), risperidone (16 articles) and olanzapine (8 articles). Division into Bradford zones yielded a nucleus occupied by the Journal of Clinical Psychopharmacology (6 articles) and the Singapore Medical Journal(4 articles). The analysed material was published in a total of 30 journals, with the majority from six journals. Four of these six journals have an impact factor greater than 2. CONCLUSION Publications on SGAs in Singapore are still too few to confirm an exponential growth of scientific literature.
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Affiliation(s)
- Francisco López-Muñoz
- Faculty of Health Sciences, Camilo José Cela University, C/ Castillo de Alarcón, 49, Urb Villafranca del Castillo, Villanueva de la Cañada, 28692 Madrid, Spain.
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Donato G, Conforti F, Allegra E. A rare case of primary nodal hemangioendothelioma. Oncol Lett 2013; 6:1759-1761. [PMID: 24260072 PMCID: PMC3834360 DOI: 10.3892/ol.2013.1631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 09/06/2013] [Indexed: 11/05/2022] Open
Abstract
Primary vascular tumors of the lymph nodes other than Kaposi's sarcoma are rare. The present study describes the case of a primary hemangioendothelioma in a cervical lymph node in a patient treated for a carcinoma of the large bowel. Microscopically, the structure of the lymph node was completely substituted by tumoral proliferation, with an architectural pattern consisting of anastomosing vascular channels, a number of which contained papillary projections or a tuft-like structure. This study demonstrates the potential diagnostic errors and hypothesizes the pathogenesis of this type of lesion; a vascular endothelial growth factor (VEGF)/VEGF receptor-3 (VEGFR-3) autocrine loop may be activated.
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Affiliation(s)
- Giuseppe Donato
- Department of Pathology, School of Medicine, University Magna Graecia, Campus of Germaneto, Catanzaro I-88100, Italy
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Abstract
A rare type of diffuse large B-cell lymphoma, intravascular large B-cell lymphoma primarily affects the middle-aged to elderly population, with a slight predominance in men. By the time of presentation, most patients have advanced, disseminated disease, and often the diagnosis is made at autopsy. Patients may present with any of a myriad of symptoms, with any tissue potentially being infiltrated. Central nervous system and cutaneous involvement is common, as is the presence of B symptoms including fever, weight loss, and night sweats. Morphologically, growth of neoplastic cells is restricted to the lumen of small vessels. The cells are large, with 1 or more prominent nucleoli, scant cytoplasm, and frequent mitotic figures, and are commonly positive for cluster of differentiation markers 79a, 20, and 19, as well as MUM1/IRF4 and Bcl-2. Intravascular large B-cell lymphoma is aggressive, and without treatment is rapidly fatal.
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Affiliation(s)
- Dennis E Orwat
- Department of Pathology, Medical University of South Carolina, Charleston, 29425, USA
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