RESUMEN
The study developed a model of composite facial and scalp allograft transplantation in canines. Dog cadavers were used for anatomy study. Three types of autotransplantations and 2 types of allotransplantations were performed. Cyclosporin A and methylprednisolone or prednisone were given for immunosuppression. Two long-term-surviving dogs with autologous facial transplantation developed leakage of salivary secretions. In the allotransplantation group (n = 5), 1 dog presented rejection at 28 postoperative days but was successfully treated and survived long term (>402 days); 1 dog died of pulmonary infection at 29 postoperative days; 3 dogs survived (>252, >222, and >201 days). Serial electromyelogram studies revealed progressive improvement of the function of the orbicularis oculi muscle. The study indicated that the unilateral superior half of the composite facial and scalp, including one third of the inferior tarsal plate and palpebral conjunctiva (type IV flap) allograft transplantation model, was an ideal model for the study of facial allotransplantation.
Asunto(s)
Cara/cirugía , Modelos Animales , Cuero Cabelludo/trasplante , Trasplante de Tejidos/métodos , Animales , PerrosRESUMEN
BACKGROUND: Sebaceous lymphadenoma of the parotid gland is a rare benign neoplasm. This is the first reported case of fine needle aspiration biopsy (FNAB) findings for sebaceous lymphadenoma of the parotid gland. CASE: A 60-year-old male presented with painless, bilateral parotid swelling noted for 5 months. The swelling was more pronounced on the right. Examination revealed bilaterally prominent parotid glands with diffuse firmness but no discrete masses. There was no evidence of facial nerve dysfunction. Laboratory evaluation was negative for infectious and autoimmune etiologies. Magnetic resonance imaging revealed bilateral cystic parotid masses. FNAB of the right parotid was obtained to assist with preoperative counseling. It revealed lymphoid and salivary gland parenchymal cells. The patient underwent a right superficial parotidectomy. The surgical specimen of the parotid mass confirmed the diagnosis of sebaceous lymphadenoma on the tissue section. The contralateral parotid mass had not been excised at this writing. CONCLUSION: This report is the first to describe the FNAB findings of the unusual benign parotid neoplasm sebaceous lymphadenoma. Though the definitive diagnosis of any parotid mass requires tissue, generally obtained via parotidectomy, an FNAB diagnosis can be useful in counseling a patient prior to definitive biopsy.
Asunto(s)
Adenolinfoma/patología , Glándula Parótida/patología , Neoplasias de la Parótida/patología , Neoplasias de las Glándulas Sebáceas/patología , Adenolinfoma/fisiopatología , Adenolinfoma/cirugía , Biopsia con Aguja Fina , Diagnóstico Diferencial , Procedimientos Quirúrgicos del Sistema Digestivo , Traumatismos del Nervio Facial/etiología , Traumatismos del Nervio Facial/fisiopatología , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Glándula Parótida/fisiopatología , Glándula Parótida/cirugía , Neoplasias de la Parótida/fisiopatología , Neoplasias de la Parótida/cirugía , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/fisiopatología , Neoplasias de las Glándulas Sebáceas/fisiopatología , Neoplasias de las Glándulas Sebáceas/cirugía , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
The authors previously showed that C34+ progenitor cells are mobilized into the peripheral blood in tumor bearers. The current study used a murine Lewis lung carcinoma (LLC) model to examine if the CD34+ cells can be chemoattracted to a tumor excision site as the first step to inducing differentiation of the attracted CD34+ cells into immune stimulatory dendritic cells (DC). Upon tumor excision, gelatin sponges were implanted into the surgical site and infused with phosphate-buffered saline or vascular endothelial cell growth factor (VEGF). The implants were removed after 4, 7, 14, and 21 days and analyzed for their cellular content. The incorporation of VEGF into implants increased the accumulation of CD34+ cells early after implantation. By day 21, the CD34+ cell content declined. However, the numbers of DCs became increased in the VEGF-containing sponges and this persisted throughout the 3-week duration of the study. The VEGF-containing implants contained a lower percentage of CD11b+ myeloid cells for the first 2 weeks after implantation as compared with the control implants. By 21 days, myeloid cell numbers declined in the control and VEGF implants. Since endothelial cell precursors have a common precursor with myeloid progenitor cells, the implants were also examined for their endothelial cell content. With increasing time after implantation, the number of endothelial cells and formation of vessel-like structures became greater in the VEGF-containing implant as compared with the control implants. These results show the feasibility of using VEGF-containing sponges to attract DC precursors and to increase the number of DCs at the tumor excision site.