Compact Endoscopy of the Larynx

2003 ◽  
Vol 112 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Christoph Arens ◽  
Thomas Dreyer ◽  
Hiltrud Glanz ◽  
Karin Malzahn
Keyword(s):  
Laryngeal Cancer ◽  
Carcinoma In Situ ◽  
Preoperative Assessment ◽  
Laryngeal Mucosa ◽  
Grade Ii ◽  
Cancerous Lesions ◽  
Epithelial Layers ◽  
Epithelial Lesions ◽  
Autofluorescence Endoscopy

In order to improve preoperative assessment of suspected precancerous and cancerous lesions of the larynx, we examined 83 patients by compact endoscopy (combination of autofluorescence and contact endoscopy) during microlaryngoscopy in a pilot study. The intraoperative findings were related to histopathologic examination. Cancerous laryngeal mucosa was illuminated during autofluorescence endoscopy by use of blue filtered light (D-light AF system) for optical demarcation of the lesion. After staining the mucosa with methylene blue (1%), we performed contact endoscopy. During autofluorescence examination of the endolaryngeal mucosa, the appearance of precancerous and cancerous lesions varied between opaque light areas and darker reddish areas. By contact endoscopy, it was possible to observe the cells, nuclei, and cytoplasm, as well as different degrees of abnormality. Histopathologic findings of 83 patients revealed laryngeal dysplasia (grade I in 29 patients, grade II in 15, and grade III or carcinoma in situ in 8) and laryngeal cancer (31 patients). In 73 cases (88%), the findings of compact endoscopy corresponded to those of histopathology. In 5 cases, epithelial lesions were overestimated because of inflammation and scarring, and 5 cases were underestimated because of hyperkeratotic thickening of the mucosa covering basal epithelial layers with focal dysplasia of grades II and III, carcinoma in situ, and microinvasive cancer. We conclude that compact endoscopy enables the laryngologist to assess laryngeal cancer and its preceding lesions more accurately during microlaryngoscopy.

Reflux Disease and Laryngeal Neoplasia in Nonsmokers and Nondrinkers

2020 ◽  
Vol 163 (3) ◽  
pp. 560-562 ◽  
Author(s):  
Sean M. Parsel ◽  
Andrew L. Iarocci ◽  
Mariella Gastañaduy ◽  
Ryan D. Winters ◽  
Jeffrey P. Marino ◽  
...  
Keyword(s):  
Laryngeal Cancer ◽  
Reflux Disease ◽  
Odds Ratio ◽  
Carcinoma In Situ ◽  
Univariate Analysis ◽  
Positive Association ◽  
Smoking History ◽  
Drinking History ◽  
History Of

Gastroesophageal reflux disease (GERD) has been hypothesized as a risk factor for development of laryngeal cancer. A case-control study was performed to assess the association of laryngeal neoplasia with GERD. Cases consisted of patients with a history of laryngeal cancer or carcinoma in situ. Controls were patients without neoplasia who matched cases 2:1 on age, sex, race, and smoking history. Univariate and multivariate analyses were performed to assess risk of laryngeal neoplasia and GERD. In total, 2094 patients were included. Cases had higher rates of GERD. Univariate analysis demonstrated a positive association between GERD and laryngeal neoplasia (odds ratio, 1.33; 95% CI, 1.07-1.64). Multivariate analysis controlling for alcohol use history also demonstrated a positive association between GERD and laryngeal neoplasia (adjusted odds ratio, 1.29; 95% CI, 1.04-1.59). These results suggest increased odds of laryngeal carcinoma and carcinoma in situ in patients with GERD when controlling for smoking and drinking history.

scholarly journals Η ποιοτική ανάλυση των μικροαποτιτανώσεων της μαστογραφίας, σε συνδυασμό με (V) DMSA και ΜΙΒΙ σπινθηρομαστογραφία, στην ανίχνευση και διαφοροδιάγνωση προδιηθητικών βλαβών του μαστού

2013 ◽  
Author(s):  
Ιουλία Χριστοδουλίδου
Keyword(s):  
Retention Index ◽  
Carcinoma In Situ ◽  
Lobular Carcinoma ◽  
Uptake Ratio ◽  
Lobular Carcinoma In Situ ◽  
Grade Ii ◽  
Grade Iii

Ο σκοπός της μελέτης είναι ο προσδιορισμός ιδιαίτερων χαρακτηριστικών στην κατανομή των (V) DΜSA και ΜIBI ραδιοφαρμάκων (ρ/φ), στον in situ πορογενή καρκίνο (DCIS) του μαστού και η συσχέτιση με την ύπαρξη ή όχι μικροαποτιτανώσεων καθώς και άλλων ιστολογικών και ανοσοϊστοχημικών παραμέτρων. Υλικό και Μέθοδος: 102 ασθενείς προσήλθαν στο νοσοκομείο ΑΛΕΞΑΝΔΡΑ για τον έλεγχο ύποπτων ψηλαφητικών ή/και μαστογραφικών ευρημάτων. Οι ασθενείς αυτές υποβλήθηκαν σε (V) DMSA ή/και MIBI σπινθηρομαστογραφία (SM), σε διαφορετικές συνεδρίες. 45 από αυτές έλαβαν και τα δύο ραδιοφάρμακα. Αποτελέσματα: Σε 46 ασθενείς επιβεβαιώθηκε ιστολογικά ο καρκίνος του μαστού. DCIS ανευρέθηκε σε 18 ασθενείς, ενώ lobular carcinoma in situ (LCIS), σε 2 ασθενείς. Σε 14/18 DCIS συνυπήρχε διηθητικός πορογενής καρκίνος (ILC), ενώ 2/2 LCIS συνδυάζονταν με διηθητικό λοβιδιακό καρκίνο (ILC). Το (V) DMSA ανίχνευσε 39/44 διηθητικές βλάβες, ενώ με το MIBI διαγνώστηκαν 29/33. Παρατηρήθηκε διάχυτη, μη σαφώς αφοριζόμενη καθήλωση του (V) DMSA, που συχνά περιέβαλε την περιοχή του IDC/ILC, σε 16/17 DCIS και σε 2/2 LCIS. Ανάλογη πρόσληψη επέδειξε και το MIBI σε 6/13DCIS-LCIS. Συμπεράσματα: Με βάση τα ευρήματα της SM, συγκριτικά με τις καλοήθειες, ο καρκίνος φαίνεται να διατηρεί υψηλούς δείκτες πρόσληψης (uptake ratio), του ρ/φ, τόσο στις πρώιμες όσο και στις καθυστερημένες λήψεις. Στις κακοήθειες ο βαθμός πρόσληψης (Τumor/Βackground), σχετίζεται με τον ιστολογικό τύπο. Ο δείκτης κατακράτησης (Retention Index), αντικατοπτρίζει το στάδιο της κακοήθειας και μπορεί να διευκολύνει στη διάκριση μεταξύ grade II και grade III καρκινωμάτων. Ο δείκτης πρόσληψης (Τ/Β ratio), παρέχει τη δυνατότητα διάκρισης μεταξύ πορογενούς και λοβιδιακού καρκίνου του μαστού.

“Early” Cancer of the Larynx: The Concept as Defined by Clinicians, Pathologists, and Biologists

1996 ◽  
Vol 105 (3) ◽  
pp. 245-250 ◽  
Author(s):  
Alfio Ferlito ◽  
Antonino Carbone ◽  
Alessandra Rinaldo ◽  
Lawrence W. Desanto ◽  
Luigi D'Angelo ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Lamina Propria ◽  
Laryngeal Cancer ◽  
Carcinoma In Situ ◽  
Early Cancer ◽  
Stage Ii ◽  
Supraglottic Cancer ◽  
Neoplastic Lesion

Since a great deal of confusion surrounds the different uses made by clinicians, pathologists, and biologists of the term, this paper clarifies the concept of “early” cancer of the larynx. Clinically, this is usually a glottic neoplasm in which full cordal mobility is still present; early supraglottic cancer is infrequent, and usually a chance finding. Whatever the site, early laryngeal cancer is a minimally invasive neoplastic lesion that does not invade the muscle or cartilage, but is still capable of metastasis. Being confined to the lamina propria, it is more than a carcinoma in situ but less than a deeply infiltrating carcinoma. Superficial extending carcinoma is therefore an early cancer. Biologically, early cancer belongs to stage II.

scholarly journals Radiopathological features predictive of involved margins in ductal carcinoma in situ

2017 ◽  
Vol 99 (2) ◽  
pp. 137-144 ◽  
Author(s):  
DM Layfield ◽  
H See ◽  
M Stahnke ◽  
L Hayward ◽  
RI Cutress ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Oestrogen Receptor ◽  
Ductal Carcinoma ◽  
Preoperative Assessment ◽  
Preoperative Imaging ◽  
High Grade ◽  
Oestrogen Receptor Status ◽  
Receptor Status

INTRODUCTION Ductal carcinoma in situ (DCIS) usually manifests as microcalcification on mammography but may be uncalcified. Consequently, a quarter of patients undergoing excision of a presumed pure DCIS require further surgery to re-excise margins. Patients at highest risk of margin involvement may benefit from additional preoperative assessment. METHODS A retrospective review was carried out of patients treated for screen detected, biopsy proven DCIS in a single centre over a ten-year period (1999–2009). Logistic regression analysis identified factors predictive of need for further surgery to clear margins. RESULTS Overall, 248 patients underwent surgery for DCIS (low/intermediate grade: 82, high grade: 155) and 49 (19.8%) required further surgery. High grade disease was associated with greater mammographic extent (mean: 32mm [range: 5–120mm] vs 25mm [range: 2–100mm]), p=0.009) and higher incidence of mastectomy (38% vs 24%, p=0.034). Factors predictive of involvement of surgical margins necessitating further surgery included negative oestrogen receptor status (OR: 5.2, 95% CI: 2.1–12.8, p<0.001) and mammographic extent (odds ratio [OR]: 1.6, 95% confidence interval [CI]: 1.2–2.1, p=0.004). Once size exceeded 30mm, more than 50% of patients required secondary breast surgery for margins. CONCLUSIONS Reoperation rates for DCIS increase with preoperative size on mammography and negative oestrogen receptor status on core biopsy. Patients with these risk features should be counselled accordingly and consideration should be given to the role of additional preoperative imaging.

1252: Impact of Concomitant Carcinoma in situ on Clinical Outcomes after Radical Cystectomy

2006 ◽  
Vol 175 (4S) ◽  
pp. 403-403 ◽  
Author(s):  
Shahrokh F. Shariat ◽  
Ganesh S. Palapattu ◽  
Gilad E. Amiel ◽  
Pierre I. Karakiewicz ◽  
Craig G. Rogers ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Radical Cystectomy ◽  
Carcinoma In Situ

Prognoseverbesserung beim DCIS: Weniger invasive Rezidive durch adjuvante Therapien

2011 ◽  
Vol 02 (03) ◽  
pp. 110-110
Author(s):  
Katharina Arnheim
Keyword(s):  
Carcinoma In Situ

Patientinnen mit duktalem Carcinoma in situ (DCIS) müssen nicht mastektomiert werden; sie haben auch nach brusterhaltender Operation ein günstiges Outcome. Eine weitere Prognoseverbesserung wird durch Nachbestrahlung und adjuvante Tamoxifen-Gabe erreicht.

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