BackgroundFine needle aspiration (FNA) biopsy has been rarely used in oral and oropharyngeal lesions. The goal of this study was to assess the value and accuracy of FNA biopsy in the diagnosis of oral and oropharyngeal lesions particularly in regards to discriminating benign from malignant tumors.MethodsSixteen cases of FNA biopsies obtained of various intraoral and oropharyngeal masses or lesions performed at our institution during the eight-year period from 1998 to 2006 were retrospectively reviewed. The aspiration cytologic diagnoses were correlated with the histologic examination of the corresponding resected lesions.ResultsSixteen cases of intraoral lesions evaluated by FNA biopsies during the period of 1998–2006 were reviewed. The sites of involvement were: lip [1], maxillary sinus [3], pharynx/oropharynx [5], floor of mouth [4], buccal mucosa [2] and peritonsillar area [1]. Patients' age ranged from 30 to 87 with an average of 54 years. Male to female ratio was 1:3. Cytologically, 7 cases were diagnosed as suspicious/malignant, and 9 cases as benign (including 6 benign neoplasm, 1 atypical, and 2 reactive or "descriptive"). Fifteen cases had corresponding surgical resection for histologic examination, of these, 9 cases were interpreted as malignant, and 6 as benign. There were no false positive diagnoses of malignancy on FNA. Two cases were interpreted as benign or atypical cytologically, but were found to be malignant on histologic examination.ConclusionFNA biopsy of intraoral and oropharyngeal masses is a valuable procedure for the initial evaluation of various lesions. It provides helpful information about these lesions and avoids hasty or unnecessary surgical biopsy. It is a rapid and relatively noninvasive procedure. Furthermore, aspiration biopsy is an important tool in the diagnosis and management of these lesions, both neoplastic and non-neoplastic, and can be sometimes complemented by ancillary studies for more accurate interpretation. However, its sensitivity in the diagnosis of malignancy is lower than that of histologic samples. This is probably due to the superficial nature and small size of these lesions, the limited space for maneuvering the needle and difficulty in immobilizing the lesion to obtain adequate samples, rather than to interpretation or inherent limitations of the technique itself.
\s=b\ Sixty patients, ranging in age from 29 to 74 years, were studied for the effect of animation of the upper half of the face on the aging features. Patients were divided into three categories according to the dominant behavioral pattern: brow lifters, frowners, and squinters. Brow ptosis was accentuated laterally in the squinters and medially in the frowners.The brow-lifter group showed more uniform displacement of the eyebrow. The coarse wrinkles or the animation lines also correlated well with the animation pattern. These patterns are acquired in childhood and remain subconsciously in effect throughout adult life and therefore have a significant effect on brow ptosis. (Arch Otolaryngol Head Neck Surg 1989;115:710-713) The body is victimized by the addi¬ tive effects of the insults to its individual cells. These can be environ¬ mental (ionizing and ultraviolet radi¬ ation, smoking, wind, etc) or internal factors, such as uncontrolled chemical reactions leading to the liberation of free radicals affecting the collagen frame or to the progressive accumula¬ tion of insoluble elements such as lipofuscin (age pigment). These are particularly noted in the nondividing Ontario, Canada M5T 2S8 (Dr Ellis). cells of the nervous and muscular systems.At the level of the molecules, pro¬ teins and nucleic acids become irre¬ versibly immobilized as a result of formation of cross-linking between molecules, restricting their activity.Genetic errors also will decrease the function of the cell, leading to its imminent fate.1 SKIN CHANGES WITH AGINGIn the analysis of many patients who undergo consultation for agediminishing surgery, the facial plastic surgeon will realize that the speed of the aging process varies among indi¬ viduals and that hereditary factors, smoking, and ultraviolet radiation exposure are the main factors acceler¬ ating this process. Skin thickness, oiliness, and skin color are the most notable hereditary factors. The thick¬ er the skin, the less it will wrinkle. As oily skin is usually thicker, the sebum oils give a protective quality to the skin that slows aging. Long-term overexposure of the skin accelerates aging. Smoking, with its inherited metabolic changes in the skin microcirculation, hastens aging, especially around the lips. These dynamic processes affect the face as a unit, but certain parts may show more deterioration. This varies according to the individual. These changes are skin sagging, fine wrin¬ kling, and deepening animation lines. Skin sagging is due to the deterioration in the collagen framework, espe¬ cially in areas supported poorly by hypotonie muscles. This is most noticeable in eyelid skin, jaw line, and cheek mounds. Skin sagging is influ¬ enced to a large degree by the effects of gravity on the soft tissue of the face.Fine wrinkling is due to the decrease in sebaceous gland activity and is most noticeable in thin and fair skin. This occurs after menopause in women and a decade later in men and is a result of atrophy of the sebaceous and eccrine glands and the dermal and subcut...
Palbociclib is a selective CDK4/6 inhibitor approved for metastatic ER+/HER2-breast cancer. Preclinical evidence suggests palbociclib can augment radiotherapy (RT) antitumor effect by 1) preventing cell cycle progression from G1 to the more radioresistant S phase and 2) inhibiting RT-induced DNA double-strand break repair. Despite this potential benefit, clinicians seldom use this combination due to fear that RT may exacerbate palbociclib toxicity, particularly hematologic. The aim of this study is to report the preliminary results of this novel combination in patients with metastatic breast cancer. Materials/Methods: Records of patients treated with palbociclib at our institution from 2015-2018 were retrospectively reviewed. Patients who received RT for symptomatic metastases concurrently or within 14 days of palbociclib were included. Local treatment effect was assessed by clinical exam and subsequent CT/MRI imaging. Toxicity was graded based on CTCAE v5.0. Results: A total of 16 women (median age: 59.6 years) received palliative RT in close temporal proximity to palbociclib administration. Four patients received palbociclib prior to RT (25.0%), 5 (31.3%) concurrent, and 7 (43.8%) post-RT. The median interval from closest palbociclib use to RT was five (range 0-14) days. The following sites were irradiated in decreasing order of frequency: bone (15 axial skeleton [9-vertebra; 4pelvis; 2-other]; 3-extremity), brain (4: 3-WBRT & 1-fSRS), and mediastinum (1). The most frequently used RT dose/fractionation by was 30 Gy in 10 fractions. The median follow-up time is 14.7 (range 1.7-38.2) months. Pain relief was achieved in all patients. No radiographic local failure was noted in the 13 patients with evaluable follow-up imaging. Leukopenia, neutropenia, and thrombocytopenia were seen in 4 (25.0%), 5 (31.3%), and 1 (6.3%) patients before RT. Following RT, 5 (31.3%), 1 (6.3%), and 3 (18.8%) patients were leukopenic, neutropenic, and thrombocytopenic, respectively. All but two (Grade 2) hematologic toxicities were Grade 1. No acute or late Grade 2+ cutaneous, neurological, or gastrointestinal toxicities were noted. Toxicity results did not differ based on disease site or palbociclib-RT temporal association. Conclusion: The use of RT in patients receiving palbociclib resulted in minimal Grade 2 and no Grade 3+ toxicities. This preliminary work suggests that symptomatic patients receiving palbociclib may be safely irradiated without discontinuation of systemic therapy. Further studies with larger cohorts are needed to confirm these results.
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