TsILINDROMA (cylindroma; lat. cylindrus, from Greek kylindros the cylinder + - from; synonym: adenokistoz-
ny cancer, a tsistadenoidny carcinoma, a basal cell carcinoma with a hyaline stroma) — the malignant epithelial tumor which is characterized by formation of tsilindropodobny structures and hyaline stromas.
Most of researchers consider that the term «tsilindrom» was offered for the first time in 1856 by T. Billroth. Existence in a tumor of so-called cylinders — roundish tsilindropodobny sites formed the basis for introduction of this term. Such structures meet also in other tumors (e.g., enclavomas of sialadens, benign tumors of skin). Therefore the term «tsilindrom» long time was associated with the long high-quality course of tumoral process, and C. carried to group of enclavomas (see) that was promoted much by often observed peculiar long course of process, and also features gistol. structures of C. (lack of signs of cellular polymorphism and mitotic activity). Afterwards it turned out that C. various localization often recur and metastasize. Therefore in a crust, time for designation of tumors of such structure the term «adenokistozny cancer» is accepted, to-ry it is included in the International histologic classification of tumors of WHO.
C. arises in sialadens more often, but can develop also in the lacrimal glands, mucous glands of upper respiratory tracts, bronchial tubes, a gullet, neck of uterus, mammary glands. From C. the listed localizations it is necessary to distinguish a benign tumor of appendages of skin — an ekkrinny skin tsilindroma (see Skin, tumors).
Macroscopically C. represents a dense node of whitish or yellowish color of a homogeneous consistence. In most cases the clear boundary between a tumor and surrounding fabrics is not defined. However at the small sizes the tumor sometimes has clear contours. At microscopic examination of C. it is characterized mo-nomorfnostyo cellular structure: it consists from enough small cells with scanty cytoplasm. Kernels of cells large with a regional glybcha-ty arrangement of chromatin. In nek-ry kernels kernels are defined. Mitoses meet seldom. Roundish spaces of various size between tumor cells are filled with slizevidny basphilic or more dense gialino-like substance (tsvetn. the tab., Art. 48, fig. 8) that gives to a tumor a characteristic trellised (cribrosa) look. Regarding cases accumulation of amorphous gialinopo-dobny substance between groups of cells is followed by formation of trabecular structures. Except the most typical and often found cribrosa option of a structure of C described., allocate solid option with a dense arrangement of tumor cells (blossoming, the tab., Art. 48, fig. 9). Irrespective of the sizes of a new growth at microscopic examination the infiltrative growth of a tumor in surrounding fabrics, quite often perineural distribution of tumor cells, as a rule, is found (tsvetn. tab., Art. 48, fig. 10).
Klin, signs of C. are a little specific and usually correspond to displays of other malignant tumors of similar localization. For example, at C. a sialaden in the form of a single node rather slow growth of a tumor is usually observed, pain is quite often noted that connect with typical for C. perineural distribution of tumor cells.
Irrespective of localization of C. it is characterized by rather long course of process, late, preferential hematogenous innidiation, a possibility of long existence of metastasises in lungs, slow increase in the sizes of metastatic nodes. Metastasises of C. in lymph nodes meet seldom.
At treatment of C. salivary, lacrimal glands and mucous glands of upper respiratory tracts the combined method — an operative measure in combination with radiation therapy is preferable. The forecast depends on localization of a tumor, its sizes p option gistol. structures.
The forecast is less favorable at localization of a tumor in small sialadens, the big sizes of primary tumor, spontanshzh paralysis of a facial nerve (at localization in a parotid gland), solid option of a structure of a new growth.
Methods of treatment of C. a gullet, a neck of uterus, a mammary gland same, as at other malignant epithelial tumors of these bodies (see the Uterus, the Mammary gland, the Gullet). The forecast in these cases is more favorable, than at other options of cancer of these localizations.
Bibliography: A pathoanatomical dia
of the Gnostic of tumors of the person, under the editorship of N. A. Krayevsky, etc., M., 1982; Evans R. W. a. CruickshankA. N of Epithelial tumors of the salivary glands, Philadelphia, 1970; L u with a s R. B. Pathology of tumors of the oral tissues, N. Y., 1976; Peters G. N. a. W about 1 f f M. Adenoid cystic carcinoma of the breast, Cancer, v. 52, p. 680, 1983. T. A. Belous.