In a previous study, we found tumor-associated tissue eosinophilia (TATE) to be a favorable prognostic indicator for squamous cell carcinoma of the head and neck (p less than 0.05). The present expanded study was undertaken to confirm this finding. The pathology of 120 head and neck tumors was examined for histologic features suggestive of poor prognosis. Ten descriptive histopathologic variables, including two malignancy grading scales, were correlated with DNA flow cytometric data and clinical outcome. No correlation was found between the malignancy grading scales and DNA flow cytometric data or clinical outcome. The present expanded study confirmed with greater statistical significance (p less than 0.001) that high-grade TATE is a favorable prognostic indicator for head and neck cancer. Furthermore, high-grade TATE was associated with the absence of distant metastasis (p less than 0.05). Using a stepwise logistic regression analysis of the clinicopathologic variables in the study, high-grade TATE was the most influential variable affecting clinical outcome, followed by border, stage, and perineural invasion. We conclude that the grade of TATE is a significant prognostic indicator for head and neck cancer. The significance and possible role of the eosinophil in the tumor-host interaction are discussed.

The pathologies of 82 head and neck tumors were examined for histologic features suggestive of poor prognoses. Twelve descriptive histopathologic variables, including two grading scales for malignant tumors, were correlated with DNA flow cytometric data and clinical outcome. We found no correlation between the grading scales and DNA flow cytometric data or clinical outcome. Only one of the histopathologic variables--stromal eosinophilia--was found to significantly correlate with favorable outcome (p = .018). Stromal eosinophilia may be an important new prognostic indicator for head and neck cancer.

The prognostic significance of deoxyribonucleic acid (DNA) flow cytometry has been investigated for many solid tumors, but few data have been accumulated for squamous cell carcinomas of the head and neck. To our knowledge, we report the largest number of patients (69) with head and neck primary carcinomas to be studied by DNA flow cytometry. In the first part of this study, we reviewed 109 consecutive patients with laryngeal or hypopharyngeal primary carcinomas which were treated at North Carolina Memorial Hospital during the period of 1981 to 1984. The final analysis comprised 139 DNA histograms (mean coefficient of variation: 8.02) on paraffin-embedded specimens from 48 patients. Of the 48 patients with primary carcinomas, 24 had glottic, 18 had supraglottic, and 6 had carcinomas from the piriform sinus. Patients had follow-up for a minimum of 12 months, with a mean follow-up period of 23 months. Twenty-three of the 48 primary carcinomas (48%) were clearly aneuploid, and the remaining 52% were tetraploid (22%) or diploid (30%). We have concluded that patients with clearly aneuploid primary carcinomas had significantly better prognoses than those with diploid tumors (p = 0.008). High DNA amounts (greater than 40% of cells beyond the diploid peak, DNA G1G0) also correlated with a favorable prognosis when compared with low DNA amounts (p less than 0.01), and this remained significant when the clinical outcome was adjusted for staging of the primary site (T), nodal status, and stage of disease. Ploidy was the most significant prognostic variable for the laryngeal group of patients. In the second part of the study, twenty-one patients with oral cavity squamous cell carcinomas were studied in a similar fashion as the group with laryngeal carcinomas. In this group, a low DNA amount, with 40% as the cutoff point, was associated with a favorable prognosis (p = 0.024), and this remained significant while controlling for T, nodal status, and stage of disease. Numbers were too small to permit evaluation of the impact of ploidy in this group, but there was a slight trend toward aneuploidy and tetraploidy, correlating with a poor treatment outcome (p = 0.228). DNA amount was the most significant prognostic variable for the group of patients with oral cavity carcinomas.(ABSTRACT TRUNCATED AT 400 WORDS)

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The clinicopathologic and ultrastructural features of a sarcomatoid carcinoma of the pancreas presenting initially as gastric carcinoma are described. By light microscopy, the tumor contained cellular patterns similar to those present in tumors of mesenchymal origin. Spindle cell areas arranged in a storiform pattern were present. Ultrastructurally, bundles of cytoplasmic microfilaments were present in the cell cytoplasm and were similar in distribution to those found on fine structural examination in tumors of mesenchymal origin. Rows of desmosomes were found between cells supporting an epithelial origin for this tumor. Following initial therapy, metastatic tumor produced polypoid lesions in the small intestine resulting in recurrent small bowel intussuceptions. Our findings indicate that sarcomatoid carcinoma of the pancreas, by both light and ultrastructural examination, is a heterogenous tumor at the cellular level and may be a cause of repeated intussuception when intraluminal compromise occurs.