Dendritic cells: friends or foes of laryngeal cancer?

BACKGROUND

Dendritic cells are important keyplayers of various malignant tumors but less studied in laryngeal malignancies. We assessed the immunohistochemical expression and distribution of dendritic cells in different types of laryngeal carcinomas and tried to find if they could influence evolution and prognosis of such malignancies.

MATERIALS AND METHODS

Immunohistochemistry was applied on 49 laryngeal tumors. Dendritic cells were identified by using S100 protein staining. The specimens were then evaluated for dendritic cells presence, number and distribution.

RESULTS

S100 positive cells were identified in all cases of squamous cell carcinoma, being absent in the case of adenoid cell carcinoma. Squamous cells carcinomas had the highest numbers of S100 positive cells. For them, we encountered an inverse correlation between peri- and intra-tumor S100 positive cells density. Intraepithelial dendritic cells density was lower for undifferentiated squamous cell carcinoma, also as for stroma of well-differentiated squamous cell carcinoma. Poorly differentiated carcinoma had a higher density of stromal S100 positive cells. S100 positive cells were identified in tumor area with squamous differentiation in all cases, and in peritumor area in 41 cases (83.67%). S100 positive cells density was correlated with tumor grade but not with invasion.

CONCLUSIONS

Taking together, our results suggest that migration of stromal dendritic cells inside tumor areas could be an important component of the antitumor immune response induction and thus, S100 positive dendritic cells may be considered as a favorable prognostic factor in laryngeal carcinomas.

Schwannoma of the lip: case report and review of the literature

Schwannomas of the lip are rare, benign neoplasms which vary in size. The diagnosis is typically made at the time of surgery following biopsy and surgical resection is the mainstay of treatment. We present one case of lip schwannoma: the patient was 25-year-old and he has presented to otorhinolaryngologist for a non-dolorous tumor on the mucosal side of his inferior lip, which was increasing in size for the last six months. The tumor had a superficial ulceration and infection. Initially it was suspected to be a papilloma. The tumor was radically removed, and the sections were stained with Hematoxylin-Eosin. The tumor was encapsulated and showed two different pattern of growth. Antoni A areas displayed spindle cells closely packed together with palisading of nuclei. Verocay bodies, which were presented in Antoni A areas, are whorled formations of palisading tumor cells. The cells of neoplasm were monotone. Only few spindle cells were moderately pleomorphic, but mitotic figures were unusual. In addition, immunohistochemical labeling was performed for S-100 protein, vimentin, GFAP and NSE and confirmed the diagnosis. This report describes a case of lip schwannoma, which was correctly diagnosed by routine staining and confirmed by immunohistochemical staining for S-100 protein, vimentin, GFAP and NSE.

Mast cell reaction in malignant laryngeal neoplasm

INTRODUCTION

Mast cells are normal connective tissue residents. Their densities vary from an organ to other, but are constantly well represented in respiratory tract. Mast cell hyperplasia was found in many malignant tumors, but the significance of this phenomenon is still unknown. In the literature, there are few data about mast cell reaction in malignant laryngeal neoplasm.

MATERIAL AND METHODS

We studied archive blocks from 127 laryngeal carcinomas. For histological diagnosis two sections were prepared for Hematoxylin-Eosin staining and Alcian blue-Safranin histochemistry at pH 0.2 for identifying mast cells. Examination has been performed with Nikon Eclipse 600 microscope. Microscopic images were analyzed with Lucia G program. Microvessel density was calculated using the hot spot method.

RESULTS

Most of the cases were squamous cell carcinoma G1 - 24.4%, G2 - 56.69%, G3 - 18.11%, and 0.78% adenoid cystic carcinoma. Invasive squamous cell carcinoma mast cell microdensity was 2.19 and 4.66 in microinvasive squamous cell carcinoma. Mast cell microdensity in malignant laryngeal papillomatosis was 9.33 and 46.66 in adenoid cystic carcinoma. In carcinoma-associated mast cell hyperplasia, the large majority of mast cells were Alcian blue positive.

CONCLUSIONS

In early stages, the mast cells are numerous (microinvasive squamous cell carcinoma mast cell microdensity 4.66) and rare or even absent in late stages (invasive squamous cell carcinoma mast cell microdensity 2.19). Mast cell microdensity in malignant laryngeal papillomatosis was 9.33 and 46.66 in cystic carcinoma. Alcianophil mast cells are present in tumor area, and safraninophil mast cells are residents of connective and muscular tissue, at a distance from the tumor.