Browsing by Author "Olsen, Kerry D."
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- High-grade transformation/dedifferentiation in salivary gland carcinomas: occurrence across subtypes and clinical significancePublication . Skalova, Alena; Leivo, Ilmo; Hellquist, Henrik; Agaimy, Abbas; Simpson, Roderick H. W.; Stenman, Goran; Vander Poorten, Vincent; Bishop, Justin A.; Franchi, Alessandro; Hernandez-Prera, Juan C.; Slouka, David; Willems, Stefan M.; Olsen, Kerry D.; Ferlito, AlfioHigh-grade transformation (HGT) or dedifferentiation has been described in a variety of salivary gland carcinomas, including acinic cell carcinoma, secretory carcinoma, adenoid cystic carcinoma, epithelial-myoepithelial carcinoma, polymorphous adenocarcinoma, low-grade mucoepidermoid carcinoma, and hyalinizing clear cell carcinoma. High-grade (HG) transformed tumors are composed of a conventional low-grade component characterized by specific microscopic and immunohistochemical features for the given entity, intermingled with or juxtaposed to areas of HG morphology. This is usually either poorly differentiated adenocarcinoma, carcinoma not otherwise specified, or undifferentiated carcinoma, in which the original line of differentiation is lost. The HG component is composed of solid nests of anaplastic cells with large vesicular pleomorphic nuclei, prominent nucleoli, and abundant cytoplasm. Frequent mitoses and extensive necrosis may be present. The Ki-67 labeling index is consistently higher in the HG component. The molecular genetic mechanisms responsible for HGT of salivary gland carcinomas are largely unknown, though p53 inactivation and human epidermal growth factor receptor 2 overexpression and/or gene amplification have been demonstrated in the HG component in a few examples, the frequency varies for each histologic type. Salivary gland carcinomas with HGT are more aggressive than conventional carcinomas, with a higher local recurrence rate and a poorer prognosis. They have a high propensity for cervical lymph node metastasis suggesting a need for a wider resection and neck dissection. HGT of salivary gland carcinoma can occur either at initial presentation or less commonly at the time of recurrence, sometimes following postoperative radiotherapy. The potential for HGT in almost any type of salivary gland carcinoma warrants a thorough sampling of all salivary gland malignancies to prevent oversight of a HG component.
- Update on olfactory neuroblastomaPublication . Lopez, Fernando; Agaimy, Abbas; Franchi, Alessandro; Suárez, Carlos; Vander Poorten, Vincent; Mäkitie, Antti A.; Homma, Akihiro; Eisbruch, Avraham; Olsen, Kerry D.; Saba, Nabil F.; Nuyts, Sandra; Snyderman, Carl; Beitler, Jonathan J.; Corry, June; Hanna, Ehab; Hellquist, Henrik; Rinaldo, Alessandra; Ferlito, AlfioOlfactory neuroblastomas are uncommon malignancies that arise from olfactory receptor cells located high in the nasal cavity. Accurate diagnosis plays a crucial role in determining clinical results and guiding treatment decisions. Diagnosis can be a major challenge for pathologists, especially when dealing with tumours with poor differentiation. The discovery of several molecular and immunohistochemical markers would help to overcome classification difficulties. Due to the paucity of large-scale studies, standardisation of diagnosis, treatment and prediction of outcome remains a challenge. Surgical resection by endoscopic techniques with the addition of postoperative irradiation is the treatment of choice. In addition, it is advisable to consider elective neck irradiation to minimise the risk of nodal recurrence. Molecular characterisation will help not only to make more accurate diagnoses but also to identify specific molecular targets that can be used to develop personalised treatment options tailored to each patient. The present review aims to summarise the current state of knowledge on histopathological diagnosis, the molecular biology and management of this disease.