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British Journal of Plastic Surgery Mar 2002Oncocytic tumours rarely affect the major salivary glands, accounting for less than 1% of all salivary-gland tumours. The World Health Organisation classification groups... (Review)
Review
Oncocytic tumours rarely affect the major salivary glands, accounting for less than 1% of all salivary-gland tumours. The World Health Organisation classification groups these tumours into three principal types: diffuse oncocytosis, focal adenomatous oncocytic hyperplasia and oncocytoma. Diffuse hyperplastic oncocytosis is the rarest lesion: only six cases have been previously reported in the literature. This condition of putative hyperplastic pathogenesis follows a benign course, whereas oncocytomas may recur after excision. No metastatic dissemination or recurrence of diffuse hyperplastic oncocytosis has been reported. We present and discuss a new case of diffuse hyperplastic oncocytosis of the parotid gland.
Topics: Biopsy, Needle; Humans; Hyperplasia; Oxyphil Cells; Parotid Gland; Parotid Neoplasms; Precancerous Conditions
PubMed: 11987951
DOI: 10.1054/bjps.2000.3768 -
Head and Neck Pathology Mar 2021Multifocal cystic oncocytosis (MCO) is a rare, benign process accounting for approximately 0.1% of salivary gland lesions. Salivary oncocytosis is characterized by...
Multifocal cystic oncocytosis (MCO) is a rare, benign process accounting for approximately 0.1% of salivary gland lesions. Salivary oncocytosis is characterized by multiple unencapsulated solid nodules of oncocytic cells derived from transformed striated ducts. MCO is a variant of salivary oncocytosis which manifests as cystically dilated striated ducts. It is difficult to obtain a definitive preoperative diagnosis of MCO; therefore, these lesions are commonly treated with surgery. We report the unique case of a 66-year-old male who previously underwent a superficial left parotidectomy for a pleomorphic adenoma. Four years later, he presented with clinical and radiographic suspicion of a multifocal recurrent pleomorphic adenoma. The patient subsequently underwent a revision parotidectomy. However, final pathology confirmed a diagnosis of MCO. Although MCO is commonly treated with surgery due to lack of a definitive preoperative diagnosis, surgery is unnecessary outside of diagnostic, functional or cosmetic considerations. Thus, if a patient with parotid oncocytosis treated by superficial parotidectomy develops disease re-manifestation in the residual deep lobe, further surgery is not indicated. There is no risk of malignant progression in this process. We report on this unusual entity as it may mimic salivary malignancy or, as in this case, recurrence of benign disease.
Topics: Adenoma, Pleomorphic; Aged; Cysts; Humans; Male; Neoplasm Recurrence, Local; Oxyphil Cells; Parotid Diseases; Parotid Neoplasms
PubMed: 32410133
DOI: 10.1007/s12105-020-01170-y -
Seminars in Nuclear Medicine Oct 2005The parathyroid glands, which usually are situated behind the thyroid gland, secrete parathyroid hormone, or PTH, which helps maintain calcium homeostasis. Primary... (Review)
Review
The parathyroid glands, which usually are situated behind the thyroid gland, secrete parathyroid hormone, or PTH, which helps maintain calcium homeostasis. Primary hyperparathyroidism results from excess parathyroid hormone secretion. In secondary hyperparathyroidism, the normal PTH effect on bone calcium release is lost. Serum PTH rises, causing generalized hyperplasia. In tertiary hyperparathyroidism, a complication of secondary hyperparathyroidism, normal feedback mechanisms governing PTH secretion are lost, parathyroid gland sensitivity to PTH decreases, and the threshold for inhibiting PTH secretion increases. 99mTc sestamibi, or MIBI, the current radionuclide study of choice for preoperative parathyroid localization, can be performed in various ways. The "single-isotope, double-phase technique" is based on the fact that MIBI washes out more rapidly from the thyroid than from abnormal parathyroid tissue. However, not all parathyroid lesions retain MIBI and not all thyroid tissue washes out quickly, and subtraction imaging is helpful. Many MIBI avid thyroid lesions also accumulate pertechnetate and iodine, and subtraction reduces false positives. Single-photon emission computed tomography provides information for localizing parathyroid lesions, differentiating thyroid from parathyroid lesions, and detecting and localizing ectopic parathyroid lesions. The most frequent cause of false-positive MIBI results is the solid thyroid nodule. Other causes include thyroid carcinoma, lymphoma, and lymphadenopathy. False-negative results occur because of several factors. Lesion size is important. Cellular function also may be important. Parathyroid tissue that expresses P-glycoprotein does not accumulate MIBI. Parathyroid adenomas that express either P-glycoprotein or the multidrug resistance related protein MRP are less likely to accumulate MIBI. MIBI scintigraphy is less sensitive for detecting hyperplastic parathyroid glands. In secondary hyperparathyroidism, MIBI uptake is more closely related to cell cycle than to gland size. Mitochondria-rich oxyphil cells presumably account for MIBI uptake in parathyroid lesions. Fewer oxyphil cells, and hence fewer mitochondria, may explain both lower uptake and rapid washout of MIBI from some lesions. MIBI is also less sensitive for detecting multigland disease than solitary gland disease.
Topics: Humans; Hyperparathyroidism; Parathyroid Glands; Parathyroid Neoplasms; Positron-Emission Tomography; Practice Guidelines as Topic; Practice Patterns, Physicians'; Prognosis; Radiopharmaceuticals; Technetium Tc 99m Sestamibi
PubMed: 16150247
DOI: 10.1053/j.semnuclmed.2005.06.001 -
Cancer Research Communications Jul 2023Hürthle cell carcinoma (HCC) is a rare type of thyroid cancer with high rates of distant metastasis and recurrence. Along with the scarcity of effective systemic...
UNLABELLED
Hürthle cell carcinoma (HCC) is a rare type of thyroid cancer with high rates of distant metastasis and recurrence. Along with the scarcity of effective systemic therapies for HCC, these factors contribute to poor clinical outcomes. The immunologic features of HCC are poorly defined and response rates with immune checkpoint blockade have not been reported. A more comprehensive understanding of the immune landscape and factors that predict response to checkpoint inhibitors is needed. We performed RNA sequencing on 40 tumors to characterize the neoantigen landscape and immune microenvironment of HCC. We analyzed transcriptomic profiles, tumor-infiltrating immune cell populations, and measures of T-cell activation/dysfunction and correlated these to genetic features such as tumor mutation burden, neoantigen burden, mitochondrial mutations, and LOH from chromosomal uniparental disomy. Finally, immune profiles of patients with recurrence were compared with those of patients without recurrence. HCC tumors exhibited low levels of immune infiltration, with the more aggressive widely invasive phenotype associated with more immune depletion. There was a negative correlation between tumor mutation burden, neoantigen burden, programmed cell death ligand 1 (PD-L1) expression, and the immune infiltration score. HCC tumors that exhibited a global LOH from chromosomal uniparental disomy or haploidization had the lowest level of immune infiltration. HCC tumors that recurred displayed an immune-depleted microenvironment associated with global LOH and aerobic glycolysis. These findings offer new insights into the functional immune landscapes and immune microenvironment of HCC. Our data identify potential immunologic vulnerabilities for these understudied and often fatal cancers.
SIGNIFICANCE
The immune landscape of HCC is poorly defined and response rates to immunotherapy have not been reported. The authors found the immune microenvironment in HCC to be depleted. This immunosuppression is associated with a global LOH from haploidization and uniparental disomy, resulting in whole chromosome losses across the genome.
Topics: Humans; Carcinoma, Hepatocellular; Liver Neoplasms; Uniparental Disomy; Oxyphil Cells; B7-H1 Antigen; Tumor Microenvironment
PubMed: 37529400
DOI: 10.1158/2767-9764.CRC-23-0120 -
Pathology, Research and Practice Oct 2017We describe the case of an oncocytic papillary cystadenoma with mucinous differentiation of the parotid gland in a 64-year-old male. Histologically, the tumor exhibited...
We describe the case of an oncocytic papillary cystadenoma with mucinous differentiation of the parotid gland in a 64-year-old male. Histologically, the tumor exhibited distinctive areas of intracystic papillary growth pattern with microcystic and macrocystic spaces containing mucinous secretions and small crystals. The cyst wall and papillary fronds were lined by oncocytic admixed with numerous mucocytes. Lymphoid tissue and invasive features were not identified. The tumor showed strong expression of CK7 and mammaglobin in oncocytes, and BRST-2 and MUC4 in mucocytes. p63, ER, PR, SOX10, DOG-1, and S100 stains were negative. No rearrangement of the MAML2 gene region or ETV6-NTRK3 fusion transcript was detected. The diagnosis of oncocytic papillary tumor with prominent mucinous differentiation is particularly problematic owing to the large number of potential mimics and should prompt consideration of appropriate molecular studies.
Topics: Biomarkers, Tumor; Biopsy; Cell Differentiation; Cystadenoma, Papillary; Diagnosis, Differential; Humans; Immunohistochemistry; Male; Middle Aged; Neoplasms, Cystic, Mucinous, and Serous; Oxyphil Cells; Parotid Neoplasms; Predictive Value of Tests
PubMed: 28756976
DOI: 10.1016/j.prp.2017.06.018 -
BMJ Case Reports May 2022Hürthle cell carcinoma (HCC) and medullary thyroid carcinomas (MTC) are uncommon histological subtypes of thyroid cancers, each accounting for around 3% of all thyroid...
Hürthle cell carcinoma (HCC) and medullary thyroid carcinomas (MTC) are uncommon histological subtypes of thyroid cancers, each accounting for around 3% of all thyroid cancers. A septuagenarian woman with a history of multiple primary cancer diagnoses presented with a growing left-sided neck lump. A diagnostic left thyroid lobectomy was performed, and pathological examination found two separate malignant foci: one HCC and an MTC. The patient developed left-sided HCC nodal metastasis, and following several multidisciplinary team discussions, a right completion lobectomy with left lateral neck dissection was performed, revealing further intrathyroidal MTC and extranodal extension of HCC. We present this as the first reported case of a collision tumour of HCC and MTC, and review the available literature regarding collision tumours and their management.
Topics: Carcinoma, Hepatocellular; Carcinoma, Neuroendocrine; Female; Humans; Liver Neoplasms; Oxyphil Cells; Thyroid Neoplasms
PubMed: 35641084
DOI: 10.1136/bcr-2022-248879 -
Clinical Nuclear Medicine Sep 2019Incidental thyroid uptake is found in approximately 2.5% of patients who undergo FDG PET for nonthyroid malignancy; approximately a third of the FDG PET thyroid...
Incidental thyroid uptake is found in approximately 2.5% of patients who undergo FDG PET for nonthyroid malignancy; approximately a third of the FDG PET thyroid incidentalomas are malignant, including primary thyroid malignancies and metastasis. We describe a 50-year-old woman, a potential heart transplant candidate with history of breast cancer, who was found by FDG PET/CT to harbor a large thyroid mass with intense FDG uptake. Biopsy and molecular study demonstrated that the thyroid mass was a Hürthle cell adenoma. This case highlights that Hürthle cell neoplasm should be included in the differential diagnosis of a thyroid nodule with very high FDG avidity.
Topics: Adenoma, Oxyphilic; Biological Transport; Diagnosis, Differential; Female; Fluorodeoxyglucose F18; Humans; Incidental Findings; Middle Aged; Oxyphil Cells; Positron Emission Tomography Computed Tomography; Thyroid Neoplasms
PubMed: 31135518
DOI: 10.1097/RLU.0000000000002617 -
Head & Neck May 2014The purpose of this study was to evaluate the clinical behavior of oncocytic Schneiderian papillomas in relation to the rate of malignant transformation and recurrences...
BACKGROUND
The purpose of this study was to evaluate the clinical behavior of oncocytic Schneiderian papillomas in relation to the rate of malignant transformation and recurrences and to report the long-term results of the endoscopic endonasal treatment.
METHODS
A retrospective analysis was carried out on patients with oncocytic papilloma, endoscopically managed over the past 20 years, at 2 university centers following a uniform policy.
RESULTS
Thirty-three patients were treated between November 1991 and December 2010. The mean follow-up period was 62 months. We observed 2 cases of persistence (6%) at the maxillary sinus level. Both of these patients underwent endoscopic surgical revision. Squamous cell carcinoma (SCC) was observed in 1 patient (3%).
CONCLUSION
The endonasal endoscopic technique proved to be a safe and effective approach for the treatment of oncocytic papillomas. An oncocytic papilloma is not to be considered a negative prognostic factor in terms of malignant transformation or recurrence.
Topics: Adult; Aged; Aged, 80 and over; Biopsy, Needle; Cell Transformation, Neoplastic; Endoscopy; Female; Follow-Up Studies; Humans; Immunohistochemistry; Italy; Magnetic Resonance Imaging; Male; Middle Aged; Nasal Cavity; Nasal Mucosa; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging; Nose Neoplasms; Oxyphil Cells; Papilloma, Inverted; Paranasal Sinus Neoplasms; Retrospective Studies; Risk Assessment; Sampling Studies; Survival Rate; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 23595801
DOI: 10.1002/hed.23341 -
Pathologica Oct 2011To date 70 cases of oncocytic carcinomas (OCs) have been described in 55 reports. We describe an OC of the parotid gland in a 56-year-old man with simultaneous breast... (Review)
Review
OBJECTIVES
To date 70 cases of oncocytic carcinomas (OCs) have been described in 55 reports. We describe an OC of the parotid gland in a 56-year-old man with simultaneous breast cancer.
METHODS
In June 2006, a 56-year-old man was referred to the Otorhinolaryngology Division for a painless right preauricolar mass. The facial nerve was functionally normal. Total parotidectomy with facial nerve preservation was performed. In January 2007, the patient was referred to the Surgical Division for a left mammary nodule. Total mastectomy with axillary lymphoadenectomy was performed.
RESULTS
The mass of the parotid gland measured 3.5 x 3 cm. Histology showed sheets, islands and nests composed of large, round to polyhedral cells with fine, granular, eosinophilic cytoplasm and round vesicular nuclei, with prominent nucleoli. The tumour cells were positive for immunohistochemical staining with antimitochondria antibodies. Histological examination of the mammary tumour showed invasive ductal carcinoma Grade III (Nottingham Histologic Score) with metastasis in 12 axillary lymph nodes. Chemotherapy was performed. At present, the patient is free of recurrences or metastases.
CONCLUSIONS
Histologically, there is a spectrum of malignant parotid gland neoplasms that have prominent eosinophilic granular cytoplasm due to increased number of mitochondria. OCs have cytoplasm packed with mitochondria, while the term "oncocytoid" should be employed for tumours that have abundant eosinophilic granular cytoplasm, but ultrastructurally do not possess marked mitochondrial hyperplasia. All reported cases of OC should be defined "oncocytic-like carcinoma" when only haematoxylin and eosin staining is performed.
Topics: Adenocarcinoma; Axilla; Breast Neoplasms, Male; Carcinoma, Ductal, Breast; Combined Modality Therapy; Disease-Free Survival; Humans; Lymph Nodes; Lymphatic Metastasis; Male; Mastectomy; Middle Aged; Neoplasms, Multiple Primary; Oxyphil Cells; Parotid Neoplasms
PubMed: 22393683
DOI: No ID Found -
European Journal of Nuclear Medicine... Feb 2021There are controversial debates if patients with Hürthle cell carcinoma, also known as oxyphilic or oncocytic cell follicular thyroid carcinoma, have a poorer outcome....
PURPOSE
There are controversial debates if patients with Hürthle cell carcinoma, also known as oxyphilic or oncocytic cell follicular thyroid carcinoma, have a poorer outcome. In this study, we systematically evaluated the clinical outcome in a large patient cohort following thyroidectomy and initial I-131 radioactive iodine therapy (RIT).
METHODS
We retrospectively evaluated a total of 378 patients with diagnosed oncocytic follicular Hürthle cell carcinoma (OFTC) (N = 126) or with classical follicular thyroid carcinoma (FTC) (N = 252). Patients received thyroidectomy and complementary I-131 RIT. Clinical data regarding basic demographic characteristics, tumor grade, persistent disease and recurrence during follow-up, and disease-free, disease-specific, and overall survival were collected during follow-up of 6.9 years (interquartile range 3.7; 11.7 years). Univariate and multivariate analyses were used to identify factors associated with disease-related and overall survival.
RESULTS
Before and after matching for risk factors, recurrence was significantly more frequently diagnosed in OFTC patients during follow-up (17% vs. 8%; p value 0.037). Likewise, OFTC patients presented with a reduced mean disease-free survival of 17.9 years (95% CI 16.0-19.8) vs. 20.1 years (95% CI 19.0-21.1) in FTC patients (p value 0.027). Multivariate analysis revealed OFTC (HR 0.502; 95% CI 0.309-0.816) as the only independent prognostic factor for disease-free survival. Distant metastases of OFTC patients were significantly less iodine-avid (p value 0.014). Mean disease-specific and overall survival did not differ significantly (p value 0.671 and 0.687) during follow-up of median 6.9 years (3.7; 11.7 years).
CONCLUSIONS
Our study suggests that recurrence is more often seen in OFTC patients. OFTC patients have a poorer prognosis for disease-free survival. Thus, OFTC and FTC behave differently and should be categorized separately. However, patients suffering from OFTC present with the same overall and disease-specific survival at the end of follow-up indifferent to FTC patients after initial RIT.
Topics: Adenocarcinoma, Follicular; Humans; Iodine Radioisotopes; Neoplasm Recurrence, Local; Oxyphil Cells; Prognosis; Retrospective Studies; Thyroid Neoplasms; Thyroidectomy
PubMed: 32683470
DOI: 10.1007/s00259-020-04952-2