Relevant bibliographies by topics / Adenoma, Pleomorphic

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  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers

Academic literature on the topic 'Adenoma, Pleomorphic'

Author: Grafiati
Published: 4 June 2021
Last updated: 17 February 2022

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Journal articles on the topic "Adenoma, Pleomorphic"

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Nishimura, Toshiro, Mitsuru Furukawa, Ei Kawahara, and Atsuo Miwa. "Differential diagnosis of pleomorphic adenoma by immunohistochemical means." Journal of Laryngology & Otology 105, no. 12 (December 1991): 1057–60. http://dx.doi.org/10.1017/s0022215100118183.

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AbstractImmunohistochemical study of major salivary gland tumours was performed on 60 pleomorphic adenomas, five basal cell adenomas and 10 adenoid cystic carcinomas to determine the diagnostic value of each antigen. Immunoreactivity examined were intermediate filaments (keratin, vimentin, desmin and glial fibrillary acidic protein [GFAP]) and related substances (actin, S-100 protein and secretory component). In pleomorphic adenomas, there was positive immunoreactivity for GFAP which was not observed in normal tissue or other neoplastic tissues. Immunoreactivity of GFAP was closely related to myxomatous and early chondromatous differentiation in pleomorphic adenoma. It is considered that GFAP immunoreactivity should be assessed in the occasional differential diagnostic dilemma of pleomorphic adenoma versus adenoid cystic carcinoma and basal cell adenoma, because of its ability to show potential and definite myxochondromatous differentiation.
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Kumar, R., D. Nair, P. Pai, and P. Chaturvedi. "Laser Resection of Subglottic Pleomorphic Adenoma." International Journal of Head and Neck Surgery 1, no. 3 (2010): 175–77. http://dx.doi.org/10.5005/jp-journals-10001-1034.

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Abstract Tumors arising from the minor salivary glands in the larynx are rare. The most common tumors occurring here are adenoid cystic carcinomas.1 Among the benign tumors, pleomorphic adenoma is the most common.1 We present a case of subglottic pleomorphic adenoma which was managed by endolaryngeal endoscopic CO2 laser surgery. Laser as a primary treatment modality for the treatment of subglottic pleomorphic adenomas has not been well-described, as only one case has been reported in literature using this modality.
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Darling, Mark R., Nelly N. Hashem, Irene Zhang, Mohamed Mohamed, Kevin Fung, Keith Kwan, Tom W. Mara, Tom D. Daley, and Eleftherios P. Diamandis. "Kallikrein-related peptidase 10 expression in salivary gland tissues and tumours." International Journal of Biological Markers 27, no. 4 (October 2012): 381–88. http://dx.doi.org/10.5301/jbm.2012.10373.

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Objectives Kallikrein-related peptidase 10 (KLK10) has been implicated in the development of several types of cancer. The purpose of this study was to analyze the expression of KLK10 in 3 types of salivary gland tumour and normal salivary glands. Materials and methods: A standard immunoperoxidase staining technique was used to assess the Immunoexpression profile of KLK10 in normal salivary glands and 3 types of salivary gland tumour: pleomorphic adenoma, adenoid cystic carcinoma and mucoepidermoid carcinoma. Results Pleomorphic adenomas showed significantly lower KLK10 levels than control tissues. Neither of the malignant tumours (adenoid cystic carcinoma and mucoepidermoid carcinoma) showed a significant alteration in the immunoreactive scores of KLK10 in comparison with the normal salivary gland tissues. KLK10 immunoreactive scores were comparable in adenoid cystic carcinoma and mucoepidermoid carcinoma. Pleomorphic adenoma had significantly lower levels of KLK10 than mucoepidermoid carcinoma. Conclusions The finding of lower KLK10 levels in pleomorphic adenoma suggests aberrant expression in a tumour that develops primarily from myoepithelial cells. A kallikrein cascade may play a role in the development and/or outcome of some salivary gland tumours.
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Paudyal, P., K. Pande, A. Pradhan, R. Shah, P. Upadhyaya, and S. Thapa. "Pleomorphic adenoma of nasal septum: A case report." Journal of Pathology of Nepal 7, no. 1 (March 30, 2017): 1133–35. http://dx.doi.org/10.3126/jpn.v7i1.16947.

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Pleomorphic adenomas are the most common benign tumor of the major salivary glands. Other rare sites for the occurrence of pleomorphic adenoma have been described in the larynx, pharynx, nasal cavity, lacrimal glands and trachea. We report here a case of intranasal pleomorphic adenoma arising from the nasal septum causing nasal obstruction which was clinically diagnosed as papilloma. Histopathology confirmed the diagnosis of pleomorphic adenoma.
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Mouzali, Amina, Samia Lameche, Assia Slimani, and Omar Zemirli. "Pleomorphic Adenoma of the Ala Nasi: A Case Report." Clinical Medicine Insights: Ear, Nose and Throat 12 (January 2019): 117955061988656. http://dx.doi.org/10.1177/1179550619886561.

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Objectives: Pleomorphic adenomas are benign tumors that rarely involve nonsalivary glands. We report an uncommon case of ala nasi pleomorphic adenoma. We discuss the clinical and histopathologic characteristics, and review the literature on nasal pleomorphic adenoma. Method: A 20-year-old man presented with a painless slow growing lobulated mass located on the right ala nasi extending into the nasal vestibule. Results: Complete surgical excision was performed. Histologic examination found a mixed cellular component: epithelial and myoepithelial cells with chondromyxoid stroma. This was consistent with the diagnosis of a typical pleomorphic adenoma. There was no evidence of recurrence at 18 months after the surgery. Conclusions: Pleomorphic adenomas located in the external nose are extremely rare. In such case, pleomorphic adenoma could originate from ectopic minor salivary gland. Complete surgical excision with long-term follow-up is recommended due to the potential risk of recurrence and malignant transformation.
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Bhandari, Anuja, Shovana Karki, and Geeta Sayami. "Carcinoma ex pleomorphic adenoma of the parotid gland with cardiac metastasis." Journal of Pathology of Nepal 8, no. 2 (September 6, 2018): 1422–24. http://dx.doi.org/10.3126/jpn.v8i2.20899.

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Pleomorphic adenomas are the most common neoplasms of the major salivary glands. They are also known as benign mixed tumors because of the presence of both epithelial and mesenchymal elements. In parotid gland, approximately 65%-75% of tumors are pleomorphic adenomas. In parotid gland, usually it occur lateral to the plane of facial nerve. They present in middle aged patients as well defined, solitary, painless mass and are slow growing tumors. Few subset of tumors may undergo malignant transformation.Carcinoma ex pleomorphic adenoma is a rare and aggressive malignancy that arises from primary or recurrent pleomorphic adenoma. It occurs in 6% of all pleomorphic adenomas. Diagnosis of malignancy and treatment is largely based on pathologic and radiographic features. Distant metastases have been reported mainly in the lung. . We present an unusual case of 68 yrs female patient with carcinoma ex pleomorphic adenoma of the parotid gland with cardiac metastasis.
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Sim, David W., Arnold G. D. Maran, and Douglas Harris. "Metastatic salivary pleomorphic adenoma." Journal of Laryngology & Otology 104, no. 1 (January 1990): 45–47. http://dx.doi.org/10.1017/s0022215100111776.

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AbstractPleomorphic adenomas of the salivary gland are usually regarded as benign tumours. We report a case in which a solitary pulmonary metastasis arose from a pleomorphic adenoma of the right parotid gland. The mechanism of metastasis is discussed.
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Sroka, Paweł, and Sławomir Okła. "Giant pleomorphic adenoma of nasal cavities and paranasal sinuses." Polski Przegląd Otorynolaryngologiczny 7, no. 1 (June 27, 2018): 1–5. http://dx.doi.org/10.5604/01.3001.0012.1467.

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Pleomorphic adenoma is benign tumor of the salivary glands. It is the most common neoplazm both major and minor salivary glands. Only in 1% of cases pleomorphic adenoma occur in the sinonasal cavities. The histopalogical wiew of pleomorphic adenomas originating from small salivary glands is different in higher cellularity and lower stromal component than those from major salivary glands. It is a benign tumor but it should be treated as a clinically uncertain. Malignant transformation of pleomorphic adenoma can occur in 2-10% of cases, The aim of this study was to present he case of 37-year-old patient with giant pleomorphic adenoma of the sinonasal cavities causing extensive destruction of sinuses and orbits walls.
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Joshi, Sushant, HS Bhuie, and Navneet Mathur. "Pleomorphic Adenoma of Nasal Cavity: A Rare Case Report." An International Journal Clinical Rhinology 7, no. 2 (2014): 67–69. http://dx.doi.org/10.5005/jp-journals-10013-1198.

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ABSTRACT Pleomorphic adenomas are most common benign tumor of the major salivary gland, mainly found in parotid gland. Pleomorphic adenomas may also occur in the minor salivary glands of the hard and soft palate. Few cases are also diagnosed in various parts of pharynx and larynx. Intranasal pleomorphic adenomas can arise either from septum or lateral nasal wall. They are very rare entity and occasionally misdiagnosed due to their atypical histopathology. We present a rare case of pleomorphic adenoma diagnosed in middle-aged female originating from lateral wall of right nasal cavity. How to cite this article Joshi S, Bhuie HS, Mathur N, Verma H. Pleomorphic Adenoma of Nasal Cavity: A Rare Case Report. Clin Rhinol An Int J 2014;7(2):67-69.
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Tejendrasingh, Thakur Rahul, and Sonawale Sanjay Kumar Laxmanrao. "Pleomorphic Adenoma of the Nasal Septum." An International Journal of Otorhinolaryngology Clinics 5, no. 3 (2013): 151–53. http://dx.doi.org/10.5005/jp-journals-10003-1132.

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ABSTRACT Pleomorphic adenoma is a common, benign tumor arising from the major salivary glands, most commonly from the parotid gland. In addition, they may also occur in the minor salivary glands of the hard and soft palate. Intranasal pleomorphic adenomas are unusual and may be misdiagnosed because they have greater myoepithelial cellularity and fewer myxoid stromata compared to those elsewhere. We report a case of pleomorphic adenoma of the nasal cavity arising from the nasal septum. How to cite this article Tejendrasingh TR, Laxmanrao SSK. Pleomorphic Adenoma of the Nasal Septum. Int J Otorhinolaryngol Clin 2013;5(3):151-153.
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Dissertations / Theses on the topic "Adenoma, Pleomorphic"

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Zbären, Sibylle. "Carcinoma ex pleomorphic adenoma : diagnostic difficulty and outcome /." Bern : [s.n.], 2008. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.

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Kjörell, Uno. "Immunological, biochemical and morphological studies on intermediate filaments." Umeå : [s.n.], 1985. http://books.google.com/books?id=6MBpAAAAMAAJ.

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Soares, Andresa Borges. "Avaliação da angiogenese e da linfangiogenese durante a progressão tumoral do carcinoma ex-adenoma pleomorfico." [s.n.], 2007. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313784.

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Orientador: Albina Messias de Almeida Milani Altemani
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
Made available in DSpace on 2018-08-09T05:51:28Z (GMT). No. of bitstreams: 1 Soares_AndresaBorges_D.pdf: 9373793 bytes, checksum: c79095bbf9f926b5658e0a10dfc3f94c (MD5) Previous issue date: 2007
Resumo: Carcinoma ex-adenoma pleomórfico (CXAP) é uma neoplasia geralmente de alto grau, com risco moderado para metástase cervical. O objetivo do trabalho foi analisar a vascularização tumoral sanguínea e linfática numa série de CXAP, que representam as diferentes fases da seqüência adenoma-carcinoma. Em oito CXAP precoces (intracapsulares ou minimamente invasores), oito avançados (francamente invasores) e 10 adenomas pleomórficos (AP) sem transformação maligna usamos os seguintes anticorpos: D2-40, Ki-67, CD34, CD105, a- SMA, CK7 e 14. A vascularização sanguínea foi estudada através da microdensidade vascular intratumoral (MDV) e área vascular total (AVT). A vascularização linfática, através da microdensidade vascular linfática (MVL) intratumoral e peritumoral. Em relação à vascularização sanguínea, a MDV pelo CD 105 mostrou forte correlação positiva com a progressão tumoral, enquanto que a MDV pelo CD 34 e a ATV não apresentaram nenhuma correlação. Carcinomas com diferenciação mioepitelial apresentavam MDV pelo CD 105 mais baixa, mas os mais altos valores de ATV. Quanto à vascularização linfática, em AP e CXAP precoces, foram encontrados raros, se algum, linfático intratumoral, enquanto que em CXAP avançados eles eram mais numerosos, porém Ki 67 negativos. Êmbolos peri e intratumorais foram vistos apenas nos CXAP sem diferenciação mioepitelial. Em conclusão, com o CD 105 demostrou-se forte correlação positiva entre angiogênese e progressão tumoral. A vascularização linfática é formada predominantemente por vasos pré-existentes, encontrados principalmente nos CXAP avançados. Tanto linfáticos intratumorais como peritumorais são condutores de êmbolos neoplásicos. CXAP com diferenciação mioepitelial mostram atividade angiogênica mais baixa associada a valores mais altos de área vascular e capacidade mais baixa para invadir vasos linfáticos
Abstract: Carcinoma ex pleomorphic adenoma (CXPA) usually is a high-grade carcinoma with a moderate risk for neck metastasis. In a series of CXPAs, which represent the different phases of the adenoma¿carcinoma sequence, we investigated lymphatic vascular density (LVD), lymph vessel endothelial proliferation and whether an angiogenic switch would take place during the malignant transformation of PA into carcinoma and during tumor progression. The CXPAs were classified into two main groups: early tumors - 8 cases (4 intracapsular and 4 minimally invasive carcinomas), and advanced tumors ¿ 8 cases (8 widely invasive carcinomas). In addition, 10 cases of pleomorphic adenoma (PA) without malignant transformation were also analyzed. The following antibodies were used: CD34, CD 105, D2-40, Ki-67, a-smooth-muscle actin, vimentin, cytokeratins 7 and 14. Microvascular density (MVD) for CD 105 increased significantly during tumor progression whereas this was not the case for CD 34 MVD. Comparing widely invasive CXPA with and without myoepithelial differentiation, CXPA with myoepithelial differentiation showed a significantly lower number of CD 105 positive vessels but revealed higher total vascular area (TVA) values. In terms of lymph vessels, PA without malignant transformation and early CXPA contained rare, if any, lymph vessels whereas in widely invasive carcinomas they were more numerous but Ki-67 negative. Carcinomatous emboli were found in peritumoral as well as in intratumoral lymphatics only in advanced CXPA without myoepithelial differentiation. In conclusion, the antibody CD 105 shows an angiogenic switch during the progression from adenoma to carcinoma in salivary glands. In terms of lymphatic vessels, in CXPA, the lymphatic network is mainly composed of pre-existing lymphatics which are mainly found in advanced CXPA. In the widely invasive CXPA, intratumoral as well as peritumoral lymphatics are a conduit for carcinoma cells. Carcinomas with myoepithelial differentiation show low angiogenesis associated with high TVA value and the neoplastic cells seem to have a lower vascular invasion capacity
Doutorado
Ciencias Biomedicas
Doutor em Ciências Médicas
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Sedassari, Bruno Tavares. "Expressão de fatores de transcrição relacionados à pluripotência de células-tronco na progressão do carcinoma ex-adenoma pleomórfico." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/23/23141/tde-03112016-195303/.

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O adenoma pleomórfico (AP) é a neoplasia mais frequente das glândulas salivares e a sua transformação maligna em um carcinoma ex-adenoma pleomórfico (CXAP) é um evento incomum que ocorre em menos de 10% dos casos. O CXAP é tipicamente uma neoplasia infiltrativa, de alto grau e associada com metástase linfonodal no momento do diagnóstico. Acredita-se que a patogênese do CXAP tenha como base o acúmulo de alterações genéticas em APs de longa duração. Evidências recentes têm demonstrado que neoplasias podem conter subpopulações de células raras, com capacidade de auto-renovação e potencial proliferativo indefinido, as chamadas células-tronco neoplásicas (CTN). As CTN parecem estar envolvidas nos processos de iniciação e progressão neoplásicas, assim como metástases e resistência terapêutica. O objetivo deste trabalho foi avaliar a expressão imuno-histoquímica, tanto nas áreas benignas quanto nas malignas, dos fatores de transcrição relacionados à pluripotência de células-tronco Bmi-1, SOX2 e Nanog em CXAPs em fases precoces (7 intracapsulares e 3 minimamente invasivos) e avançada (14 francamente invasivos) de progressão histológica. A análise dos resultados de imuno-histoquímica foi realizada de maneira semi-quantitativa de acordo com o escore 0 (ausência de células positivas), 1 (<30% de células positivas), 2 (30-60% de células positivas e 3 (>60% de células positivas). Correlacionou-se, ainda, esses resultados com parâmetros anatomopatológicos de agressividade neoplásica através do teste Exato de Fisher. A parótida foi a glândula mais acometida em ambos os grupos (62,5%), e homens e mulheres foram igualmente acometidos. A média de idade foi 61,1 anos. No grupo de CXAPs precoces, Bmi-1 foi expresso no componente carcinomatoso de todos os casos e em escassas células das áreas benignas de 1 caso. O fator SOX2 foi expresso pelas células carcinomatosas em 90% desses casos e em escassas células do AP residual de 1 caso. Já Nanog foi expresso apenas no componente maligno de 60% dos casos. Por outro lado, Bmi-1 foi expresso nas áreas malignas de 71,4% dos CXAPs avançados e em ocasionais células da área benigna de 1 caso. O AP residual de nenhum caso desse grupo foi positivo para SOX2 e Nanog, que foram expressos pelas áreas malignas em 92,8% e 35,7% dos casos, respectivamente. Assim, notou-se queda na expressão de Bmi-1 e Nanog na progressão do CXAP. Ainda, a expressão de SOX2 parece correlacionar-se com necrose neoplásica (p=0,06) e metástase linfonodal ao diagnóstico (p=0,08), entretanto a amostra estudada parece pequena para evidenciar esse dado estatístico. Concluiu-se que Bmi-1, SOX2 e Nanog são superexpressos na transformação maligna do AP. Entretanto, Bmi-1 e Nanog aparentemente não exercem função determinante no processo de progressão neoplásica, ao passo que SOX2 parece contribuir com o processo de metástase em CXAP.
Pleomorphic adenoma (PA) is the most common salivary gland tumor and its malignant transformation into a carcinoma ex pleomorphic adenoma (CXPA) is an unusual event occuring in less than 10% of the cases. The CXPA is typically an infiltrative and high-grade neoplasm at diagnosis associated with lymph node metastases. It is believed that the pathogenesis of CXPA is based on the accumulation of genetic changes in long-standing PAs. Recent evidences have shown that tumors may contain subpopulations of rare cells, capable of self-renewal, and with indefinite proliferative potential, the so-called neoplastic stem cells (NSC). The NSC appears to be involved in neoplastic initiation and progression, as well as metastasis and treatment resistance. The objective of this study was to evaluate the immunohistochemical expression of stem cell-related pluripotency transcription factors Bmi-1, SOX2, and Nanog in benign and malignant areas of CXPA at early (7 intracapsular and 3 minimally invasive) and advanced (14 frankly invasive) stages of histological progression. Immunohistochemical analysis was performed semiquantitatively according to the scores 0 (no positive cell), 1 (<30% positive cells), 2 (30-60% of cells positive, and 3 (>60% positive cells). These results were also correlated with pathological parameters of neoplastic aggressiveness using the Fisher\'s Exact test. The parotid gland was the most affected site in both groups (62.5%), and men and women were equally affected. The mean age was 61.1 years. In the early CXPA group, Bmi-1 was expressed in carcinomatous component of all cases and in occasional cells of benign areas of 1 case. The SOX2 factor was expressed by the carcinomatous cells in 90% of cases and scant cells in residual PA of 1 case. Nanog was expressed in 60% of cases, only in the malignant component. On the other hand, Bmi-1 was expressed in malignant areas of 71.4% of advanced CXPAs and in occasional cells of benign area of 1 case. The residual PA of none of the cases in this group was positive to SOX2 and Nanog, which were expressed by carcinomatous areas in 92.8% and 35.7% of cases, respectively. Thus, it was noted that Bmi-1 and Nanog expression decreases in CXPA progression. Yet, SOX2 expression seems to be correlated with neoplastic necrosis (p= 0.06) and lymph node metastasis at diagnosis (p=0.08), but the current sample seems to be small to evidence this statistic data. It was concluded that Bmi-1, Nanog, and SOX2 are overexpressed in malignant transformation of PA. However, Bmi-1 and Nanog apparently do not exert a decisive role in the process of neoplastic progression, while SOX2 seems to contribute to the process of metastasis in CXPA.
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Ronquillo, Yasmyne Castillo. "The Mechanisms of Malignant Transformation in Benign Salivary Gland Tumors." University of Toledo / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1250207420.

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Marques, Yonara Maria Freire Soares. "Estudo da expressão das proteínas MDM2, P53, P21WAF1 e AKT em neoplasias benignas de glândula salivar." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/23/23141/tde-19032007-170028/.

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A proteína P53 pode estar virtualmente alterada em todos os cânceres humanos e portanto, na ausência de mutação, uma possibilidade para a inativação da p53 é a formação de complexo com outras proteínas, tal como a proteína Mdm2. Estudos prévios realizados em nosso laboratório demonstraram a superexpressão de Mdm2 na ausência de expressão da proteína P53 em adenomas pleomórficos. O objetivo deste estudo foi analisar a expressão das proteínas Mdm2, P53, P21 e Akt em adenoma pleomórfico e o mioepitelioma através das técnicas de imunoistoquímica, western blotting e imunofluorescência. A superexpressão de Mdm2 e Akt foi encontrada na maioria das linhagens e lesões utilizadas neste estudo enquanto as proteínas P53 e P21 não demonstraram expressão nas neoplasias estudadas. As superexpressões das proteínas Mdm2 e Akt estão relacionadas à tumorigênese em neoplasias benignas de glândula salivar.
The P53 protein can be altered in virtually all human cancers and in the absence of mutations, P53 inactivation is possible via complex formation with others proteins, such as the Mdm2. Previous studies from our laboratory showed overexpression of mdm2 and lack of p53 expression in pleomorphic adenomas. The aim of this study was to analyze the expression of Mdm2, P53, P21 and Akt proteins in pleomorphic adenomas and myoepiteliomas by Western blotting, immunohistochemistry and immunofluorescence techniques. Overexpression of Mdm2 and Akt was present in the majority of cell lineages and tumors studied, while the expression of P53 and P21 proteins was considered absent. Overexpression of Mdm2 and Akt are related to the tumorigenesis of benign salivary gland neoplasms.
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Carvalhosa, Artur Aburad de. ""Pesquisa dos receptores de estrógeno (RE) e do receptor da progesterona (RP) in vivo e verificação da influência destes hormônios in vitro em duas linhagens de adenomas pelomórficos"." Universidade de São Paulo, 2001. http://www.teses.usp.br/teses/disponiveis/23/23141/tde-02042004-115521/.

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RESUMO A similaridade entre o tecido da mama e o da glândula salivar está bem estabelecida. A porção das estruturas acinares e ductais destes órgãos são basicamente semelhantes. Estes aspectos, associados ao fato de que uma coexistência de carcinomas da mama e de glândula salivar, têm sido relatados em uma incidência maior do que a esperada. Guiaram estudos tentando determinar a importância dos receptores de estrógeno e progesterona em adenomas pleomórficos (AP). A neoplasia é mais freqüente nas glândulas salivares e exibe uma predileção para o sexo feminino. Recentemente a presença do receptor de estrógeno (RE) e do receptor de progesterona (RP) tem sido investigada no AP, entre outras neoplasias de glândula salivar, questionando-se a possibilidade da existência da dependência hormonal. A expressão dos receptores hormonais nos carcinomas de mama é importante para determinar o prognóstico e a probabilidade de responder à manipulação hormonal. Neoplasias que apresentam positividade para ambos os receptores, estrógeno e progesterona, exibem maior probabilidade de resposta à terapia anti-estrogênica do que as neoplasias que são negativas para estes receptores. Baseando-se na literatura científica pertinente, o presente trabalho se propõe a investigar a presença da proteína RE e da proteína RP em APs humanos, relacionando-os com a proliferação de linhagens celulares sob a influência destes hormônios. A técnica utilizada foi a imuno-histoquímica para a pesquisa dos RE e RP em 10 APs emblocados em parafina pertencentes ao arquivo do Serviço de Patologia Cirúrgica da FOUSP, e de duas linhagens de APs estabelecidas no mesmo serviço: uma derivada de um paciente do sexo masculino e a outra de um paciente do sexo feminino. No meio de cultivo onde subculturas destas células proliferavam foram diluídos 17-b-estradiol e progesterona. Através de contagens destas células em períodos pré-determinados (24 horas, 48 horas e 72 horas), pretendeu-se verificar a influência dos respectivos hormônios na multiplicação celular. Como controle positivo utilizou-se uma linhagem denominada T-47D, que foi largamente estudada na literatura. A T-47D é derivada de um carcinoma metastático de mama, reconhecidamente hormônio dependente. E como controle negativo, utilizou-se de uma linhagem de carcinoma epidermóide, denominada HN30. Encontrou-se positividade para o RE em 7 de 10 APs estudados (4 em homens e 3 em mulheres) e positividade para o RP em 8 Aps estudados (4 em mulheres e 4 em homens). Pela análise estatística, constatou-se que existe uma diferença significativa no índice proliferativo entre o controle e as células submetidas à ação do 17-b-estradiol e da progesterona. Para a linhagem derivada do paciente do sexo masculino houve diferença entre o controle e as células expostas ao 17-b-estradiol e a progesterona somente nas últimas 72 horas. Para a linhagem derivada do sexo feminino constatou-se uma diferença significativa entre o controle e as células sob a influência da progesterona, a partir de 48 horas de proliferação celular. A diferença significativa entre o controle e as células sob a ação do 17-b-estradiol ocorreu somente a partir das 72 horas, sugerindo que o AP poderia ser uma neoplasia influenciada pela ação hormonal.
SUMARY It is well established the similarity between mammary and salivary glands especially between the acinic and ductile structures. These aspects, associated to the fact of coexistence of breast carcinomas and of salivary gland tumors been described, leaded studies in attempt to determine the importance of the ERs and Pr in pleomorphic adenomas (PA), the most frequent salivary gland tumor and with predilection for the females. Lately, the presence of ERs and of the PRs has been investigated in PA and other salivary gland tumors pointing out their hormonal dependency. The expression of hormone receptors in breast carcinomas is crucial to determine a presence for both receptors. These tumors exhibit better response to anti-estrogenic therapy than the negative ones. Basing on the pertinent scientific literature, the present study proposes to investigate the presence of the RE and of the RP in humans PA and connecting them with cellular proliferation in vitro, under the influence of these hormones. Immunohistochemistry technique was used for the detection of RE and RP in paraffin embedded 10 PAs from the files of the Department of Oral Pathology, School of Dentistry, University of São Paulo, and two PA cell lines one from a male patient and other female. The culture midia was supplied with, 17-b-estradiol and progesterone. A growth curve was performed (24 hours, 48 hours and 72 hours) to verify the influence of the respective hormones in the cellular proliferation. As a positive control T-47-D cells derived from a hormone dependent metastatic breast carcinoma were used, and as negative control HN30 cells, derived from a tongue squamous cell carcinoma. 7 of 10 PAs were positive (4 in men and 3 in women) for RP and 8 of 8 PAs (4 in women and 4 in men) for RE. The statistical analysis verified a significant difference in the proliferative index between the control cells and the ones submitted to the action of the 17-b-estradiol and of the progesterone: for male derived lineage a difference was only observed in the last 72 hours. In the other hand, for the female derived lineage a significant difference was verified starting from 48 hours, suggesting that PA can be influenced by hormonal action.
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Ferreira, Jean Carlos Barbosa. "Adenoma pleomórfico de glândulas salivares menores: investigação do potencial neoplásico baseado na apoptose, atividade mucosecretora e proliferação celular." Universidade Federal de Goiás, 2014. http://repositorio.bc.ufg.br/tede/handle/tede/3636.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
Pleomorphic adenoma (PA) is the most common salivary gland tumor, however its etiopathogenesis is unclear, as well as your neoplastic potential. Studies have already been done investigating apoptosis, mucosecretory activity and proliferation cellular, although these studies are controversial. The aim of this study was to investigate the neoplastic potential of the PA of minor oral salivary glands measured by apoptosis (Bcl-2, Bax and p53), mucosecretory activity (MUC1), and cellular proliferation (Ki-67). Thirty-one cases of PA of the oral cavity and 4 controls (C) taken from normal oral minor salivary glands were analyzed by immunohistochemistry technique. The proteins were detected utilizing a semi-quantitative method (scores) as follows: (-) negative ≤ 5%, (+) low 6–25%, (++) moderate 26–50% and (+++) high >50% of positive tumour cells. The apoptotic indices were evaluated by the ratio Bcl-2/Bax. Non-parametric comparison and correlation tests were used for analysis. The data showed high staining of anti-apoptotic protein Bcl-2 in both groups (PA= 57.9%; C=67.7%) and an expression significantly lower of pro-apoptotic protein Bax (PA=22.7%; C=97.7%) and MUC1 (PA=14%; C=82.3%) in PA than in C (p<0.001). On the other hand, we observed a similar expression of Ki-67 and p53 proteins (≤ 5%) in both PA and C. In PA, only 2 cases showed the ratio Bcl-2/Bax <1. There was no difference in cellular expression with regard to clinical variables clinical and outcome (p>0.05). The neoplastic potential of PA can be associated with an imbalance in apoptotic processes and a lower index of proliferation cellular and that the mucosecretory activity does not play a significant role in primary PA.
Adenoma Pleomórfico (AP) é o tumor de glândula salivar mais comum, entretanto sua etiopatogênese permanece incerta bem como seu potencial neoplásico. Estudos têm sido realizados no intuito de investigar apoptose, atividade mucosecretora e proliferação celular em AP, entretanto estes trabalhos são controversos. O objetivo deste estudo foi investigar o potencial neoplásico do AP de glândulas salivares menores de boca mensurados pela apoptose (Bcl-2, Bax e p53), atividade mucosecretora (MUC1) e proliferação celular (Ki-67). Trinta e um casos de AP da cavidade oral e quatro controles (C), biopsiadas de glândulas salivares menores orais normais foram analisadas através da técnica imuno-histoquímica. As proteínas foram detectadas utilizando um método semi-quantitativo (scores) seguindo os seguintes critérios: (-) negativa ≤ 5%, (+) baixa 6-25%, (+ +) moderada 26-50% e (+ + +) alta > 50% expressão de células tumorais marcadas positivamente. Para avaliação dos índices de apoptose, a razão Bcl-2/Bax foi utilizada. Comparação não paramétrica e testes de correlação foram utilizados para a análise. Os dados mostraram elevada marcação de proteína antiapoptótica Bcl-2 em ambos os grupos (AP = 57,9% C = 67,7%) e uma expressão significativamente mais baixa da proteína pró-apoptótica Bax (AP = 22,7% C = 97,7%) e MUC1 (AP = 14% C = 82,3%) em AP do que em C (p <0,001). Por outro lado, observou-se uma expressão semelhante de Ki-67 e p53 (≤ 5%) em ambos os grupos. Em AP, apenas 2 casos apresentaram a relação Bcl-2/Bax <1. Não houve diferença na expressão celular, no que diz respeito às variáveis clínicas e o desfecho (p> 0,05). O potencial neoplásico do AP pode ser associado a um desequilíbrio nos processos apoptóticos, e os baixos índices de proliferação celular e a atividade mucosecretora parece não desempenhar papel significativo no AP primários.
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Matuck, Bruno Fernandes. "Expressão de E-caderina e Beta-catenina na área carcinomatosa do carcinoma ex-adenoma pleomórfico." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/23/23154/tde-04042018-105844/.

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O carcinoma ex-adenoma pleomórifoco (CXAP) é a contraparte maligna do Adenoma pleomórfico (AP), sendo sua malignização descrita em 10% dos AP. Histológicamente o CXAP apresenta grande variação morfológica vista a capacidade do componente maligno se originar de diferentes estruturas do componente misto do AP. Nota-se que grande parte dos CXAP apresentam caráter infiltrativo, metástase linfonodal e metástase tardia. Para que as células neoplásicas adquiram um fenótipo com maior capacidade infiltrava é necessário que passem por um processo de transição de um fenótipo epitelial para mesenquimal. Este processo é conhecido como Transição epitélio-mesênquima (TEM). Tal processo é visto em situações fisiológicas, tais quais, migração de células ectodérmicas durante o período embriológico, reparação e cicatrização e também em processos neoplásicos. O objetivo deste trabalho é avaliar a presença de proteínas inerentes ao processo de transição epitélio mesênquima e comparar a expressão destas proteínas com achados histopatológicos sugestivos de invasão e mestástase. A análise das proteínas E-caderina e Beta-catenina em células neoplásicas de CXAP foi realizada de forma semi-quantitativa conforme sugerido pela literatura. Os casos foram subdividos de acordo com a positividade da reação de imunohistoquímica. Onde houve ausência de células positivas o caso recebeu escore 0, casos onde houve <10% de células positivas o escore foi 1, casos onde 10- 75% de células positivas escore 2 e consequentemente 3 para casos em que >75% das células eram positivas. Tais achados foram relacionados com presença de invasão angiolinfática, perineural, metástase tardia, recorrência e metástase linfonodal. De um total de 16 casos de CXAP, o sitio mais acometido foi a parótida e 53% da nossa amostra era composta por homens, a idade média foi de 52,9 anos e a parótida foi o sitio mais acometido. A análise histopatológica demonstrou que quando havia marcação para E-caderina a mesma se dava em membrana celular. 12,5% ausência de marcação, 50% dos casos com marcação fraca 31,25% dos casos com expressão moderada e 6,25% dos casos com marcação intensa. Já para Beta-catenina um caso apresentou marcação citoplasmática e os restantes em membrana celular.18,75% ausente de marcação, 25 % com marcação fraca, 50% dos casos com marcação moderada e 6,25 dos casos com marcação intensa. A imuno-marcação estava distribuída de forma difusa tanto no front de invasão quanto no parênquima do carcinoma. Casos com maior presença de E-caderina apresentaram mais metástases linfonodais, p=0,035. Para outros critérios de invasão nenhuma relação estatística significante foi observada. Sugere-se que E-caderina e Beta-catenina não fazem parte do processo de invasão e metástase de CXAP nem são fatores relacionados a invasão dos tecidos adjacentes.
Carcinoma ex-pleomorphic adenoma (CXAP) is the malignant counterpart of pleomorphic adenoma(PA), although malignant transformation of PA is unusual occurring in 10% of the PA cases. The CXAP histologically presents an intense morphologic variation due to the ability of the malignant tissue to originate from any structure of de mixed component. A significant number of CXAPs show an infiltrative behavior, lymph node metastasis and late metastasis. The cell component must undergo a morphologic alteration changing the epithelial phenotype to a mesenchymal one. That development process is known as epithelial-mesenchymal transiction (MET). This process is seen in physiologic situations, like cell migration on embryologic ectodermal evolution, tissue repair and int neoplastic processes. The main objective of this study was to evaluate immunohistochemical expression of epithelial-mesenchymal transiction proteins, e-caderin and beta-catenin in malignant areas of CXAP and correlate with pathologic parameters that indicates migration, like perineural and angiolymphatic invasion and metastasis as suggested by the literature. Immunohistochemical analysis was performed semiquantitatively according to the scores 0 (no positive cell), 1 (<10% positive cells), 2 (10-75% of cells positive, and 3 (>75% positive cells). These results were also correlated with pathological parameters of neoplastic aggressiveness using the Fisher\'s exact test. Of the16 cases, the parotid gland was the most involved site and men were affected in 53.8 % of our sample. The mean age was 52.9 year. The histopathological analysis showed that in all cases in which e-caderin was positive, the immunoreaction was of the cell membrane 12,5% of the cases showed absent of e-caderin expression, 50% showed weak expression, 31,25% showed moderate expression and 6,25 show strong one. In the other hand, b-catenin showed cytoplasmic expression in one case, all other cases showed protein in cell membrane. 18,75 showed absent expression, 25% showed weak expression, 50% showed moderate and 6,25% showed intense one. The immunohistochemical reaction was diffuse and presented itself in invasion front as well as in the carcinoma parenchyma. Cases presenting high expression of e-caderin developed more lymph node metastasis, p=0,035. For the others invasion parameters there was no statistic summary observed. This work suggest that e-caderin and b-catenin have no relation to CXAP carcinogenesis or invasion process
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Cavalcante, Roberta Barroso. "Altera??es nos genes da E-caderina e ?-catenina em adenoma pleom?rfico e carcinoma aden?ide c?stico: estudo molecular e imuno-histoqu?mico." Universidade Federal do Rio Grande do Norte, 2008. http://repositorio.ufrn.br:8080/jspui/handle/123456789/17140.

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Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico
Pleomorphic adenoma and adenoid cystic carcinoma represent a benign and malignant salivary gland neoplasm, respectively, that shares the same histological origin, however with distinct biological behavior. The aim of the present study was identify the -160 C/A polymorphism in the gene CDH1, mutational analysis of CTNNB1 gene and evaluation the expression of the E-cadherin and ?-catenin in pleomorphic adenomas and adenoid cystic carcinomas. Furthermore, it was proposed correlate the immunochemistry staining patterns with the polymorphism and mutations. Twenty-four pleomorphic adenomas and 24 adenoid cystic carcinomas were retrieved. The polymorphism analysis was performed by restriction fragment length polymorphism (RFLP), using the restriction enzymes HphI or AflIII and the mutational screening was performed by PCR-single strand conformational polymorphism (PCR-SSCP). The immunohistochemical analysis was taken by the counting of cells, recorded as the Hscore index, and considering the presence or absence, intensity, distribution and localization of proteins expression. Comparing the two neoplasms, the results demonstrated statistically significant difference for the E-cadherin and ?-catenin expression, with pleomorphic adenoma presenting weaker immunostaining. Was observed statistical correlation between E-cadherin and ?-catenin expression. CDH1 heterozigotic polymorphism was seen in two cases and 13 cases displayed abnormal mobility electrophoretic shifts, suggesting CTNNB1 gene mutation. The immunohistochemical expression was not statistically correlated with the polymorphism or suggested mutations. In conclusion this study supports that the E-cadherin/?-catenin complex immunohistochemical expression might be related with the myoepithelial component amount and differentiation neither the tumor biological behavior. The cases that showed E-cadherin gene polymorphism presented reduced protein expression and, moreover, CTNNB1 suggested mutations seem not influence in the ?-catenin protein expression
O adenoma pleom?rfico e o carcinoma aden?ide c?stico representam neoplasias de gl?ndula salivar benigna e maligna, respectivamente, que compartilham a mesma origem histol?gica, por?m com comportamentos biol?gicos distintos. O prop?sito deste estudo consistiu na identifica??o do polimorfismo -160 C/A da regi?o promotora do gene CDH1 (E-caderina), na triagem de muta??es no gene CTNNB1 (?-catenina), e ainda na an?lise da express?o imuno-histoqu?mica das prote?nas E-caderina e ?-catenina em adenomas pleom?rficos e carcinomas aden?ides c?sticos. Al?m disso, objetivou-se correlacionar os achados imuno-histoqu?micos com as poss?veis muta??es e polimorfismo. Foram selecionados 24 casos de adenoma pleom?rfico e 24 casos de carcinoma aden?ide c?stico. Para a identifica??o do polimorfismo no gene da E-caderina empregou-se a t?cnica RFLP (restriction fragment length polymorphism) utilizando-se enzimas de restri??o HphI e AflIII. A triagem de muta??es no exon 3 do gene da ?-catenina foi realizada por meio de SSCP (single strand conformational polymorphism). Para a an?lise imuno-histoqu?mica, procedeu-se contagem de c?lulas, por meio do ?ndice HScore e verificou-se presen?a ou aus?ncia, intensidade, padr?o de distribui??o e localiza??o celular e tecidual das prote?nas. Os resultados demonstraram diferen?a estatisticamente significativa quando a marca??o imuno-histoqu?mica, tanto da E-caderina quanto ?-catenina, foi comparada entre as duas neoplasias estudadas, apresentando o adenoma pleom?rfico express?o reduzida. Observou-se correla??o estatisticamente significativa entre a imuno-marca??o da E-caderina e ?-catenina. Dois casos (1 adenoma pleom?rfico e 1 carcinoma aden?ide c?stico) apresentaram polimorfismo heterozig?tico no gene CDH1 e 13 casos (6 adenomas pleom?rficos e 7 carcinomas aden?ides c?sticos) exibiram varia??o no padr?o de corrida eletrofor?tica, sugerindo muta??o do gene CTNNB1. N?o houve correla??o estatisticamente significativa entre a marca??o imuno-histoqu?mica e presen?a de polimorfismo ou poss?veis muta??es. Conclui-se que a express?o imuno-histoqu?mica do complexo E-caderina/?-catenina pode estar relacionada com a quantidade e diferencia??o do componente mioepitelial e n?o ao comportamento biol?gico dos tumores. Os casos que exibiram polimorfismo no gene da E-caderina apresentaram redu??o na express?o prot?ica e, por fim, as poss?veis muta??es no gene CTNNB1 parecem n?o influenciar na express?o da prote?na ?-catenina
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Books on the topic "Adenoma, Pleomorphic"

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Color atlas/text of salivary gland tumor pathology. New York: Igaku-Shoin Medical Publishers, 1996.

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Book chapters on the topic "Adenoma, Pleomorphic"

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Fraire, Armando E., Philip T. Cagle, and Timothy C. Allen. "Pleomorphic Adenoma." In Atlas of Neoplastic Pulmonary Disease, 35–37. Boston, MA: Springer US, 2009. http://dx.doi.org/10.1007/978-0-387-89839-1_7.

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Vass, Laszlo. "Pleomorphic Adenoma." In Encyclopedia of Geoarchaeology, 340–44. Dordrecht: Springer Netherlands, 2016. http://dx.doi.org/10.1007/978-3-319-28618-1_1816.

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García, Joaquín J. "Pleomorphic Adenoma." In Atlas of Salivary Gland Pathology, 153–60. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-09021-4_22.

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Daugherty, Larry C., Brandon J. Fisher, Christin A. Knowlton, Michelle Kolton Mackay, David E. Wazer, Anthony E. Dragun, James H. Brashears, et al. "Pleomorphic Adenoma." In Encyclopedia of Radiation Oncology, 631. Berlin, Heidelberg: Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-540-85516-3_638.

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Feng, Jining, and Mousa A. Al-Abbadi. "Pleomorphic Adenoma." In Salivary Gland Cytology, 57–67. Hoboken, NJ, USA: John Wiley & Sons, Inc., 2011. http://dx.doi.org/10.1002/9780470932087.ch5.

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Hellquist, Henrik, and Alena Skalova. "Pleomorphic Adenoma." In Histopathology of the Salivary Glands, 67–100. Berlin, Heidelberg: Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-540-46915-5_3.

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Vass, Laszlo. "Pleomorphic Adenoma Metastasizing." In Encyclopedia of Geoarchaeology, 344–47. Dordrecht: Springer Netherlands, 2016. http://dx.doi.org/10.1007/978-3-319-28618-1_1830.

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Sharma, Vijay. "Pleomorphic Adenoma, Lung." In Encyclopedia of Pathology, 317–19. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-69263-0_300.

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Vass, Laszlo. "Carcinoma Ex Pleomorphic Adenoma." In Encyclopedia of Soil Science, 50–53. Dordrecht: Springer Netherlands, 2016. http://dx.doi.org/10.1007/978-3-319-28618-1_1829.

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García, Joaquín J. "Pleomorphic Adenoma, Carcinoma Ex." In Atlas of Salivary Gland Pathology, 161–69. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-09021-4_23.

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Conference papers on the topic "Adenoma, Pleomorphic"

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Viviane Mariano, Fernanda, and Beatriz Samara De Brito. "ANALYSIS OF PLAG1 EXPRESSION IN PLEOMORPHIC ADENOMA AND CARCINOMA EX PLEOMORPHIC ADENOMA." In XXIII Congresso de Iniciação Científica da Unicamp. Campinas - SP, Brazil: Galoá, 2015. http://dx.doi.org/10.19146/pibic-2015-38237.

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Knoke, M., V. Gudziol, J. Reden, M. Meinhardt, M. Kemper, and T. Zahnert. "Pleomorphic adenoma with pulmonary metastases." In Abstract- und Posterband – 90. Jahresversammlung der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie e.V., Bonn – Digitalisierung in der HNO-Heilkunde. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1686854.

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Reichenstein, M., M. Aldahlawi, S. Jaschinski, and G. Wolf. "Pleomorphic Adenoma of the Nose." In 100 JAHRE DGHNO-KHC: WO KOMMEN WIR HER? WO STEHEN WIR? WO GEHEN WIR HIN? Georg Thieme Verlag KG, 2021. http://dx.doi.org/10.1055/s-0041-1728635.

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Lee, Seungjae, Sumit Borah, Kurt Patton, and Armita Bahrami. "Abstract 2395: Differentiation of carcinoma ex pleomorphic adenoma from pleomorphic adenoma byTERTpromoter hypermethylation and elevatedTERTmRNA expression." In Proceedings: AACR Annual Meeting 2017; April 1-5, 2017; Washington, DC. American Association for Cancer Research, 2017. http://dx.doi.org/10.1158/1538-7445.am2017-2395.

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Martin, M., J. Benckendorff, Jörg Lindemann, MO Scheithauer, TK Hoffmann, and F. Sommer. "Pleomorphic adenoma of the orbit – a case report." In Abstract- und Posterband – 91. Jahresversammlung der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie e.V., Bonn – Welche Qualität macht den Unterschied. © Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1711347.

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Prera, E., E. Bakry, H. Herbst, T. Fischer, and P. Mir-Salim. "Zeruminal pleomorphic adenoma ("mixed tumor") of the ear canal." In Abstract- und Posterband – 89. Jahresversammlung der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie e.V., Bonn – Forschung heute – Zukunft morgen. Georg Thieme Verlag KG, 2018. http://dx.doi.org/10.1055/s-0038-1640131.

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Gong, Liang, Xiang-Dong Zhou, He-Ping Yang, Yu-Ju Shen, Jian He, and Ding-Yuan Liu. "A Case Report On Pleomorphic Adenoma In Right Main Bronchus And Related Reference Analysis." In American Thoracic Society 2011 International Conference, May 13-18, 2011 • Denver Colorado. American Thoracic Society, 2011. http://dx.doi.org/10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a3828.

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Ianez, Renata, Marcilei Buim, Cláudia Coutinho-Camillo, Fernando Soares, and Silvia Lourenço. "Abstract 5352: Investigation of stem-cell markers in pleomorphic adenoma: Immunohistochemical and molecular study." In Proceedings: AACR 103rd Annual Meeting 2012‐‐ Mar 31‐Apr 4, 2012; Chicago, IL. American Association for Cancer Research, 2012. http://dx.doi.org/10.1158/1538-7445.am2012-5352.

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Diab, K. J., and S. Mitri. "Primary Endobronchial Pleomorphic Adenoma of the Lung Resected Through the Use of Cryotherapy with Complete Macroscopic Resolution." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a4876.

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10

Heine, D., G. Psychogios, H. Rüger, and J. Zenk. "Synchronous unilateral pleomorphic adenoma and cystadenolymphoma of the parotid gland: two case reports and review of the literature." In Abstract- und Posterband – 89. Jahresversammlung der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie e.V., Bonn – Forschung heute – Zukunft morgen. Georg Thieme Verlag KG, 2018. http://dx.doi.org/10.1055/s-0038-1641004.

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