선양낭성암종(Adenoid Cystic Carcinoma)에서의 Glycosaminoglycan의 발현에 관한 연구

손창원(Chang-Won Son),김경욱(Kyung-Wook Kim),김철환(Chul-Hwan Kim) 대한구강악안면외과학회 2004 대한구강악안면외과학회지 Vol.30 No.4

Adenoid cystic carcinoma is malignant tumor in salivary gland, and its behavior is very invasive. Of all malignant tumor adenoid cystic carcinoma is occured in frequency of 4.4% in major salivary gland, and 1.29% in minor salivary gland. Histopathologically, adenoid cystic carcinoma is characterized by a cribriform appearance, and tubular form and solid nest type tumor can be seen. The tumor cell structure composed of modified myoepithelial cell, and basaloid cell. Extracellular matrix of this tumor cell contains variable ground substance with basement membrane component. Basement membrane matrix composed of collagen fibers, glycoproteins, proteoglycans, and its function is well known that it participate in differentiation, proliferation, and growth of tumor cell. Basement membrane molecule is essential for invasion of peripheral nerve, blood vessel, skeletal muscle in tumor cell of adenoid cystic carcinoma. In many studies, the tumor cell of adenoid cystic carcinoma containing modified myoepithelial cell participate in synthesis of proteoglycan. In this study, tissue sample of adenoid cystic carcinoma of human salivary gland were obtained from 15 surgical specimen, and all specimen were routinely fixed in 10% formalin and embedded. Serial 4-㎛ thick sections were cut from paraffin blocks. the histopathologic evaluation was done with light microscopy. And, the immunohistochemical staining, characteristics of glycosaminoglycan were observed. For biochemical analysis of glycosaminoglycan, isolation of crude glycosaminoglycan from tumor tissue and Western bolt analysis were carried out. With transmission electomicroscopy, tumor cell were observed. Biologic behavior of adenoid cystic carcinoma was observed with distribution and expression of basement membrane of glycosaminoglycan in tumor cells, The results obtained were as follows: 1. In immunohistochemical study, chondroitin sulfate is postively stained in tumor cell and interstitial space, dermatan sulfate is weakly stained in ductal cell. But keratan sulfate is negatively stained. 2. In immunohistochemical study, heparan sulfate is strong positive stained in tumor cell and basement membrane, especially in invasion area to peripheral nerve tissue. 3. In transmission electromicroscpic view, the tumor cells are composed modifed myoepithelial cells, and contains many microvilli and rough endoplasmic reticulum. 4. In Western blot analysis, the expression of glycosaminoglycan is expressed mostly in heparan sulfate. From the results obtained in this study, tumor cell of adenoid cystic carcinoma is composed modified myoepithelial cell, and glycosaminoglycan of basement membrane molecule of heparan sulfate and chondroitin sulfate mostly participate in the development and invasiveness of adenoid cystic carcinoma by immunohistochemical study and western blot analysis.

타액선 악성선상낭종과 조직학적 등급과의 관계

박윤규(Yoon Kyu Park),박성길(Sung Gil Park),이삼열(Samu el Lee),오성수(Sung Soo Oh),이혜경(Hye Kyung Lee) 대한두경부종양학회 1991 대한두경부 종양학회지 Vol.7 No.2

This is a clinical, retrospective review of 66 cases of the Adenoid cystic carcinoma who were treated at the Department of Surgery, Presbyterian Medical Center, Chonju during the past 20 years from January, 1971 to December, 1990. The results were obtained as follows; 1) The most common malignant tumor in the minor salivary gland was adenoid cystic carcinoma and it's incidence was 57.6% (38 cases). 2) The most common site of adenoid cystic carcinoma in the major salivary gland was parotid gland with the incidence of 22.7% (15 cases). 3) The peak age of patients with adenoid cystic carcinoma was 5th decade(30.3%) and others' peak age except adenoid cystic carcinoma was 6th decade(35.9%). 4) The duration of symptoms of adenoid cystic carcinoma patient was less than one year in the minor salivary gland, comprising 21 cases(55.3 %) and more than one year in 18 cases(64.9 %) of the major salivary gland carcinoma. 5) According to histologic grades of 66 cases of adenoid cystic carcinoma, Grade I was 15 cases and Grade II 19 cases, Grade III 5 cases. Other 27 cases were undetermined. 6) The incidence of cervical lymphnode metastasis of 39 cases of adenoid cystic carcinoma classified into histologic grades was 0% in Grade I, 10.5% in Grade II and 20% in Grade III. 7) The incidence of nerve invasion confirmed histologically was 20% in Grade I, 63.2% in Grade II and 100% in Grade III. It was significant(p<0.01). 8) The local recurrence rate was 26.7% in Grade I, 47.4% in Grade II and 60% in Grade III. The lung was the commonest site for distant metastasis comprising 14 cases among 19 cases in which distant spread occurred. 9) 5 year determinate disease-free survival rate according to the histologic grade was 57.1% in Grade I, 27.33 in Grade II and 25.03 in Grade III. 10) The determinate 5-year survial rate of adenoid cystic carcinoma was 71.4% in the only curative surgery group, 70.6% in the combined treatment group of surgery and postoperative irradiation, 66.7% in the combined treatment group of surgeη with postoperative irradiation and chemotherapy, and 33.3% in the non-curative treatment group. 11) The average size of tumor was 3.6cm in Grade I, 4.8cm in Grade II and 4.5cm in Grade III.

이하선 선상 낭성암의 피부 전이

박연호(Yeon Ho Park),이동원(Dong Won Lee),조백기(Baik Kee Cho) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.2

Adenoid cystic carcinoma is known to be a neoplasm of the major and minor salivary glands but it also occurs in the lacrimal gland, external auditory canal, easphagus, breast and skin. Adenoid cystic carcinoma of salivary gland is a slow-growin nalignant tumor. Although metastasis of this tumor clevelnps in about half the cases, its meta taes to the overlying skin is not common, moreover the skin metastasis to the remote site is raely found. Primary cutaneous adenoid cystic carcinoma is rare and histologically indistingisl able from skin metastasis of adenoid cystic carcinoma of the salivary gland. A 53 year-old man presented a solitary, well defined, erythen at us, 1.3 x 1.3cm sized nodule on the vertex of the scalp, which revealed the typical histopatholog ndings of adenoid cystic carcinoma. One and half years ago, a tumor of the parotid gland va removed and proved to be a cribriform pattern of adenoid cystic carcinoma. The skin lesion was diaghosed as a skin metastasis of the alenoid cystic carcinoma of parotid gland rather than a primary cutaneous adenoid cystic carcinona because a similar pattern of adenoid cystic carcinorom had been discovered on the parotidg an l although it developed on the scalp, the usual site of primary cutaneous adenoid cystic carcinama. (Kor J Dermatol 1995; 33 (2): 327-331)

두경부 영역에 발생한 선양낭성암종에서 CK7, CK19, CK20, SMA 및 Ki-67의 발현에 관한 면역조직화학적 연구

문영은(Young Eun Moon),정우진(Woo Jin Jeong),이동욱(Dong Wook Lee),송형근(Hyung Geun Song) 대한두경부종양학회 2009 대한두경부 종양학회지 Vol.25 No.2

Objectives :The aim of this study was to investigate immunohistochemical expression of CK7, CK19, CK20, SMA and Ki-67 in Adenoid cystic carcinoma(ACC) of the Head and Neck. Material and Methods :Sixteen patients who were treated in Chungbuk National University Hospital from 1992 to 2004, were included in this study. Ten ACCs, 3 MECs, 1 Salivary duct carcinoma, 1 Adenocarcinoma(NOS), and 1 cacinoma ex pleomorphic adenoma were analyzed immunohistochemically for CK7, CK19, CK20, SMA, and Ki-67. Results :CK7 was expressed in 100% of the adenoid cystic carcinoma and 75% of the other tumors. CK19 was expressed in 75% of the adenoid cystic carcinoma and 100% of the other tumors. CK20 was not expressed in all tumors. SMA was expressed in 88.9% of the adenoid cystic carcinoma and not expressed in the other tumors. Ki-67 was expressed in low level in the adenoid cystic carcinoma. Conclusion :The Ki-67 index could explain the natural course of tumor. Immunohistochemistry of CK7, CK19, CK20, SMA and Ki-67 expression in Adenoid cystic carcinoma may provide useful information to diagnosis.

이소성 눈물샘 선양낭성암종 1례

주영훈,오현진,최봉진,강준명 대한비과학회 2009 Journal of rhinology Vol.16 No.1

Adenoid cystic carcinoma (ACC) of the lacrimal gland is a rare malignant tumor accounting for 1.6% of all orbital tumors. We report a case of ectopic adenoid cystic carcinoma that developed on the nasal orbital side of the face adjacent to the nasal cavity. A 60-year-old man developed progressive right ocular proptosis and pain for over three years. The orbit MRI and CT revealed a 24×36×17 mm-sized lower signal mass on the medial side of the right medial rectus muscle. It also showed an erosion of the orbital bone in the superior and medial orbital walls. An endoscopic biopsy was performed and a frozen section of the tissue in the operating room showed no evidence of a malignancy. The mass was excised by endoscopic surgery. The final pathology was an adenoid cystic carcinoma. An orbital exenteration was recommended but the patient refused the procedure and, after receiving chemotherapy and radiation therapy, his condition is being followed. Some of the orbital mass remains in the posterior orbital area immediately after the endoscopic excision. The patient underwent his first session of Cyberknife radiosurgery therapy after concurrent chemotherapy and radiotherapy. Adenoid cystic carcinoma (ACC) of the lacrimal gland is a rare malignant tumor accounting for 1.6% of all orbital tumors. We report a case of ectopic adenoid cystic carcinoma that developed on the nasal orbital side of the face adjacent to the nasal cavity. A 60-year-old man developed progressive right ocular proptosis and pain for over three years. The orbit MRI and CT revealed a 24×36×17 mm-sized lower signal mass on the medial side of the right medial rectus muscle. It also showed an erosion of the orbital bone in the superior and medial orbital walls. An endoscopic biopsy was performed and a frozen section of the tissue in the operating room showed no evidence of a malignancy. The mass was excised by endoscopic surgery. The final pathology was an adenoid cystic carcinoma. An orbital exenteration was recommended but the patient refused the procedure and, after receiving chemotherapy and radiation therapy, his condition is being followed. Some of the orbital mass remains in the posterior orbital area immediately after the endoscopic excision. The patient underwent his first session of Cyberknife radiosurgery therapy after concurrent chemotherapy and radiotherapy.

외음부에 발생한 원발성 피부 선상 낭종성 암의 치험례

정회준,손대구,권선영 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.3

Purpose: Adenoid cystic carcinoma is a rare type of eccrine sweat gland carcinoma. Although it is mostly known as a neoplasm of the salivary gland, it could occur as a primary skin tumor. We present a patient with a primary cutaneous adenoid cystic carcinoma at the genital area.Methods: A 60-year-old man had a slowly growing 1 cm sized single tender mass near the left scrotum and he underwent excisional biopsy at a local clinic. A diagnosis of adenoid cystic carcinoma was made and thus he was transferred to our hospital. In physical examination, other specific findings were not detected except a linear scar caused by a previous skin biopsy near the left scrotum. In CT scan, PET-CT scan and endoscopy, there was no evidence of neoplasm in other organs. It was diagnosed as the primary cutaneous adenoid cystic carcinoma and then wide excisions were performed including total 4.5cm margin of normal skin.Results: Microscopic findings revealed proliferation of tumor cell islands with cribriform or tubular patterns containing several round, pseudocystic structures. The tumor cells showed basaloid cells with uniform and small nuclei. Tumor cells infiltrated into the dermis and upper portion of subcutaneous tissue. There was multifocal perineural invasion of tumor cells. In postoperative 6 months, we found no recurrence and other complications.Conclusion: Herein we found a rare case of primary cutaneous adenoid cystic carcinoma at the genital area.

Bronchial Brushing Cytologic Finding of Primary Pulmonary Adenoid Cystic Carcinoma Misinterpretated as Small Cell Carcinoma - A Case Report with Literature Review -

김현정,최상봉,권지은,김정연,박경미 대한병리학회 2011 Journal of Pathology and Translational Medicine Vol.45 No.4

An adenoid cystic carcinoma is a very rare primary pulmonary neoplasm. Bronchial washing and brushing cytological findings of pulmonary adenoid cystic carcinoma have rarely been described. Here, we report the bronchial brushing cytological findings of an adenoid cystic carcinoma, finally diagnosed in a 71-year-old female patient. The low-power view showed moderate cellularity and cohesive clusters of small to medium-sized cells. The high-power view revealed distinct nuclear moldings, a coarse chromatin pattern, and inconspicuous nucleoli, which was favorable to a diagnosis of small cell carcinoma. However, apoptotic bodies, nuclear debris, and mitoses were not seen frequently. The bronchial biopsy showed solid, trabecular, and cribriform patterns in small cells. Periodic acid Schiff staining disclosed globular basement membrane-like materials, and the immunohistochemical staining revealed the presence of myoepithelial cell components, strongly suggestive of a salivary gland type tumor, compatible with an adenoid cystic carcinoma. In this report, we describe the exfoliative cytological features of a pulmonary adenoid cystic carcinoma with emphasis on some diagnostic pitfalls.

두개강내 전이를 동반한 Adenoid Cystic Carcinoma의 다발성 전이

박봉진,성정남,조맹기,김영준 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.9

악성 타액선 종양의 방사선 치료 성적에 대하여 -원자력 병원의 10년 경험 ($1975.1{\sim}1984.12$)-

조철구,고경환,류성렬,박영환,박우윤,심윤상,오경균,Cho Chul Koo,Koh Kyoung Hwan,Yoo Seong Yul,Park Young Hwan,Park Woo Yoon,Shim Young Sang,Oh Kyung Kyoon The Korean Society for Radiation Oncology 1990 Radiation Oncology Journal Vol.8 No.1

1975년 1월부터 1984년 12월까지 원자력병원 치료 방사선과에서 악성 타액선 종양으로 방사선 치료를 받은 58명의 환자를 대상으로 하여 이들의 생존율을 후향적으로 분석하였다. 이들은 수술후 재발했거나, 수술이 불가능한 환자들이었다. 58명의 환자중 mucoepidermoid carcinoma를 가진 환자가 $43.1\%$, adenoid cystic carcinoma를 가진 환자는 $41.3\%$였다. 주 타액선 종양의 5년 보험생존율은 $68.2\%$, 10년 생존율은 $31.8\%$였으나, 무병생존율은 각각 $43.2\%\;13.0\%$로써 치료 후 재발된 상태에서도 비교적 오래 산다는 것을 알 수 있었다. TNM staging에 의한 생존율도 $T_1$의 5년 생존율이 $86.5\%,\;T_2+T_3$가 $40.0\%,\;T_4$가 $0\%$로, T stage가 높아지면 질수록 생존율도 현저히 감소하였다. 병리조직학적 관점에서 볼 때, adenoid cystic carcinoma의 5년 무병생존율은 $40.1\%$로써, mucoepidermoid ca.의 $49.8\%$보다 낮았으나, 전체적인 생존율은 $77.3\%$로써, mucoepidermoid ca.의 $51.5\%$보다 현저히 높았다. 따라서, adenoid cystic carcinoma는 치료실패후 병을 가진 상태에서도 상당 기간 생존할 수 있다는 것을 알았으며, 평균 생존기간은 2년 이었다. 또한 mucoepidermoid ca.인 경우에는 세포의 분화정도에 따라 생존율이 달라졌는데, 저등도 분화세포의 5년 생존율이 $78.8\%$로 고등도 분화세포의 $38.2\%$보다 거의 2배나 높았다. 암의 위치와 성별에 따른 생존율의 차이는 없었다. Minor salivary gland tumor는 6명으로 5년 보험생존률은 $32.3\%$였다. 따라서 주 타액선 종양의 생존율에 영향을 끼칠 수 있는 예후 인자는 1) 병리조직학적 세포종류, 2) T와 N stages (AJCC), 3) mucoepidermoid carcinoma에 있어서 분화 정도 였다. Retrospective analysis of survival rates was undertaken in the patients of 58 cases treated with conventional radiation therapy for malignant salivary gland tumors between January 1975 and December 1984 in Korea Cancer Center Hospital (KCCH). They were patients whose long-term follow-up was possible and who had refused surgery or had had recurrences postoperatively. Out of 58 patients, 25 patients ($43.1\%$) had mucoepidermoid carcinomas and 24 patients ($41.3\%$) adenoid cystic carcinoma. Total actuarial survival rates at 5 years and 10 years were $68.2\%\;and\;31.8\%$ respectively, but disease-free survival rates, $43.2\%\;and\;13.0\%$, respectively. According to TNM stage, the survival rates at 5 years were $86.5\%$ in $T_1,\;40.0\%\;in\;T_2+T_3,\;and\;0\%\;in\;T_4$. In terms of histologic types, 5 years disease-free survival rate of adenoid cystic carcinomas ($40.1\%$) was lower than that of mucoepidermoid carcinomas ($49.8\%$) but overall survival rate ($77.3\%$) was much higher than that of mucoepidermoid carcinomas ($51.5\%$). There-fore, we concluded that the patients, who had had disease after failure of treatment, could survive during a certain period of time and their alive times were 2 years on the average. There was a difference in survival rates in the mucoepidermoid carcinomas in terms of histological grade of differentiation and it was a arbiter in prognosis: 5 YSR of low-grade was $78.8\%$ and higher 2 times than that of high-grade. There was no difference in survival rates according to location and sex. The number of patients having minor salivary gland tumors was 6 cases and their actuarial 5 YSR was $32.3\%$. Consequently, prognostic factors which influence the survival rates of patients with malignant salivary gland tumors are thought to be 1) histological subtypes 2) T and N staging (AJCC) 3) histological grade, especially in mucoepidermoids.

자궁경부의 Adenoid basal carcinoma 1례

박동춘(Dong Choon Park),김재훈(Jae Hoon Kim),이형근(Hyung Gun Lee),정대영(Dae Young Chung),김진우(Jin Woo Kim),유영옥(Young Ok Lew),김대훈(Dae Hoon Kim),남궁성은(Sung Eun NamKoong) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.8

We report a rare case of adenoid basal carcinoma in uterine cervix. The patient was a 43-year-old Korean female. She received neoadjuvant chemotherapy with Quick Cis-VP16 (cisplatin and VP16 with 7-10 days interval), three times and radical hysterectomy with pelvic lymph nodes dissection under the diagnosis of cervical cancer stage IIa. After the neoadjuvant chemotherapy, the mass size was 3 x 2.5 Cm and which was protruded in exocervical region. Microscopically, scattered small nests of uniformed small cells with dark nuclei and scant cytoplasm were observed. Peripheral palisading as well as the formation of gland-like or acinar structures were noted. There were also foci of squamous differentiation in same portion of the small nests. The epithelial surface in other portions showed squamous cell carcinoma, large cell non-keratinizing cell type. Distribution between adenoid basal carcinoma of the cervix and other disease, such as adenoid cystic carcinoma and squamous cell carcinoma with basaloid features, is important for clinical management because the clinical behavior of adenoid basal carcinoma is less malignant than adenoid cystic carcinoma.