Fifteen oncocytic (oxyphilic granular cell) neoplasms of the salivary glands collected from three large university medical centers are presented. The histologic and ultrastructural criteria that characterize oncocytes are presented and electron micrographs of two of our cases are discussed. Included in the series are 10 benign oncocytomas, two malignant oncocytomas and three benign, oncocytic pleomorphic adenomas. The clinical and pathologic features of benign oncocytomas are reviewed, with special attention to the variety of gross and microscopic changes present. The literature on malignant oncocytomas is critically reviewed, diagnostic criteria are evaluated, and a unique case is discussed in detail. Reference is made to a group of neoplasms that we designate as benign locally aggressive oncocytomas. The problem of differential diagnosis between oncocytoma and bening, oncocytic pleomorphic adenoma is considered.
Six cases are presented of an entity which previously had been described as lymphangiopericytoma, but which now are considered to be more correctly termed “lymphangiomyoma” An additional 14 cases from the literature are reviewed. The lesion, which shows a striking female sex predominance, often involves the thoracic duct, has an almost constant association with chylothorax and a frequent one with pulmonary disease consisting of lymphangiectasis, honeycombing with proliferation of smooth muscle and atypical lipid pneumonia, possibly of chylous origin. No lesion has metastasized to distant organs or invaded organs locally and the authors conclude that the lesion is best considered as a hamartoma, often of multifocal origin. A close relationship is noted between lymphangiomyoma and certain secondary lesions associated with tuberous sclerosis. The clinical course and response to therapy are described.
Fifty cases of histologically proven invasive squamous cell carcinoma of the vulva were reviewed. It was found that 2 of the patients had extensive areas of adenoid squamous cell carcinoma, and 15 had focal changes. The adenoid variety of squamous cell carcinoma consists of rounded spaces, lined by squamous cells primarily of one cell thickness, and conatining in the lumen single or grouped dyskeratotic acantholytic cells. The incidence of lichen sclerosus et atrophicus in the 50 patients with squamous carcinoma of the vulva was found to be 18%. There was no statistical significance in the observed difference in mortality between patients with adenoid squamous and the usual variety of squamous cell carcinoma. Adenoid squamous carcinoma, which is often attributed to solar damage, has previously been described only in sun‐exposed areas of the skin. Our report is the first describing this entity in the vulva.
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