Yoshimi Miyajima

Analysis of expression of matrix metalloproteinases-2 and -9 in hypopharyngeal squamous cell carcinoma by in situ hybridization.

The gene expression of two type IV collagenases (matrix metalloproteinase [MMP]-2, a 72 kd type IV collagenase, and MMP-9, a 92 kd type IV collagenase) was investigated in carcinomas of the hypopharynx. We examined 27 cases operated on in our hospital by an in situ hybridization technique to detect their messenger RNA signals in cancer cells and surrounding stroma. Both signals were detected in all cancer nests and in stromal cells in the same specimens. Clinicopathologic studies showed a significant relationship between MMP-2 expression in the primary cancer and the outcome of treatment. Our present study suggests that hypopharyngeal squamous cell carcinoma producing MMP-2 has a high potential for invasion and metastasis and a poor outcome. The analysis of MMPs will be useful for treatment planning in hypopharyngeal carcinoma and for prognosis.

Cultured stellate cells in human vocal fold mucosa

OBJECTIVES Stellate cells in the maculae flavae, located at both ends of the human vocal fold mucosa, have been considered an independent category of cells. We aimed to isolate and subculture these stellate cells, and to observe their morphological characteristics. METHODS Stellate cells from the maculae flavae and fibroblasts from Reinkes space were cultured in three normal, adult human vocal fold mucosa preparations. RESULTS The subcultured cells from Reinkes space were conventional fibroblasts. The subcultured cells from the maculae flavae were stellate in shape and had cytoplasmic processes. They were larger than conventional fibroblasts, and lipid droplets in the cytoplasm disappeared in the second culture. These stellate cells proliferated by attaching their cytoplasmic processes to each other. During the seven to 10 month subculture period, each cell type continued to exhibit its own morphological characteristics. CONCLUSION This study demonstrated that such stellate cells form an independent cell category, which should be considered as a new category of cells within the human vocal fold.

The immunohistochemical expression of p21WAF1/Cip1 and Proliferating cell nuclear antigen in laryngeal squamous cell carcinomas.

The purpose of this study was to assess the significance of the expression of p21WAF1/Cip1 and proliferating cell nuclear antigen (PCNA) in human laryngeal squamous cell carcinomas. Forty-eight patients (25 supraglottic, 23 glottic) who had undergone operations between 1998 and 2003 were included in this study. The Envision immunohistochemistry method was utilized to stain these tissue specimens. The results showed that the immunostaining of p21WAF1/Cip1 do not show any correlation with differentiation, N stage, metastasis, survival, recurrence or the laryngeal site of involvement. A significant inverse correlation was detected between p21WAF1/Cip1 and the T stage. In contrast, the percentage of PCNA labelled cells showed a significant correlation with the T stage, but not with other clinicopathological parameters. There were differences in the expression of p21WAF1/Cip1 and PCNA between the supraglottic and the glottic carcinomas. In conclusion, our findings suggest that p21WAF1/Cip1 and PCNA may play an important role in the progression of carcinoma of the supraglottic larynx.

Plexiform schwannoma of the neck extending deeply to the mediastinum.

We describe a 42-year-old man who had tumors occupying the right deep neck through the upper part of the mediastinum. The right vocal cord was fixed and bulgings of the pharyngeal and tracheal wall were observed. At surgery, the masses were subtotally removed as much as possible. Histological examination revealed that they were schwannomas. The postoperative course was uneventful, except for the presence of hoarseness.

Ki-1 positive B-cell lymphoma with bizarre giant cells

A 55-year-old woman had complained of swelling on the left side of the neck for 3 weeks. The tumor involved lateral cervical, and inguinal lymph nodes and the faucial tonsil on the left side. The histological diagnosis was Ki-1 positive, non-Hodgkin B-cell lymphoma, with diffuse large cells and bizarre giant cells. Under electron microscopic examination, the tumor cells contained markedly cleaved nuclei, many mitchondria and lamellar rough endoplasmic reticulum. This is the fourth case of Ki-1 positive B-cell lymphoma reported in Japanese literature.

Two Cases of Soft Tissue Tumor Arising in the Deep Neck

We encountered two rare cases of soft tissue tumor arising in the deep neck. The first case was a 29-year-old woman diagnosed as having pseudomalignant osseous tumor. At surgery, a circumscribed, hard mass was found in the deep portion and adhered to the cervical vertebra. The mass was extirpated together with a layer of the surrounding macroscopically intact tissue. The post-operative course was uneventful. The second case was a 59-year-old man diagnosed as having epithelioid sarcoma. At surgery, a circumscribed, invasive mass was found in the deep portion and adhered to the cervical vertebra. The mass was excised together with adjacent muscle tissue and fat tissue. The post-operative course was uneventful. Immunohistochemical evidence in these cases are also presented.

Indication of Preventive Neck Dissection for Carcinoma of the Tongue.

The validity of supraomohyoid neck dissection (SOND) for T1/T2 carcinoma of the tongue was investigated. One hundred eight patients underwent CO2 laser resection between March 1980 and April 1997 in Kurume University Hospital. Metastatic lymph nodes were recognized in 41 patients (38%) throughout the follow-up intervals, and radical or modified radical neck dissection was performed in these patients. Occult neck metastasis was seen in 20 patients (19%). Five patients died of neck metastasis, and all of them showed recurrence at the neck after initial treatment. Twenty patients showed positive neck metastasis in the initial treatment. Metastatic lymph nodes were limited to the supraomohyoid area in patients who underwent RND or m-RND as an initial treatment. In contrast, in 21 patients who received RND or m-RND after the initial treatment, metastatic nodes were detected in jugular regions, too. Metastasis to the caudal deep cervical lymph nodes were seen in 2 patients. These results indicate that: (1) supra-omohyoid neck dissection would be satisfactory as an initial treatment to prevent neck dissection for T1/T2 carcinoma of the tongue, and (2) radical neck dissection is required for patients with neck recurrence.