Abstract Malakoplakia is a rare, granulomatous disease that affects a wide variety of organs and can have a clinical and radiographic presentation resembling that of malignancy. The genitourinary tract is the most commonly involved site. There are scant reported cases presenting as a locally advanced renal mass and even rarer, diagnosed by fine‐needle aspiration (FNA) cytology. We report clinical, imaging, cytologic, and histological findings of an interesting case of malakoplakia initially diagnosed...
Sat May 02, 2020 16:55
Abstract Cytology serves a fundamental role in the evaluation of the lower respiratory tract. Cytological specimens are often the first diagnostic attempt for the evaluation of radiographic alterations. The categorization of the pathological process as infectious, inflammatory or neoplastic is critical in guiding further clinical management of the affected patient. Therefore it is imperative that cytopathologists use a standardized approach to sample handling and reporting in order to establish...
Sat May 02, 2020 15:48
Abstract Introduction Guided fine‐needle aspiration cytology is a popular investigative procedure in diagnosing pulmonary lesions. The Papanicolaou Society of Cytopathology (PSC) has already outlined a categorical system for reporting respiratory cytology. Though each category has a known malignancy risk, their inter observer reproducibility have not been well documented. This study was directed towards establishing the reproducibility of this categorical system in diagnosing pulmonary lesions....
Thu Apr 30, 2020 19:05
Abstract Background Fine‐needle aspiration (FNA) is an important tool for the diagnosis of infectious diseases. In this study, we assessed the efficacy of FNA cytology in early diagnosis of fungal infections. Methods This was a retrospective study from January 2016 to August 2018. Electronic archives were searched for FNAs from superficial and deep lesions obtained from various sites with the diagnosis of fungal infection. Each case was evaluated for underlying predisposing conditions,...
Thu Apr 30, 2020 18:00
Abstract Lung cancer is the leading cause of cancer‐related death worldwide. It is divided into sub‐categories based upon morphology, immunostaining pattern, biology, molecular profile, and/or treatment options. Up until the early 2000s when driver mutations with targeted therapies were identified in a subset of adenocarcinomas, the most critical distinction of lung carcinomas was driven by differences in treatment between small cell carcinoma (SCC) and nonsmall cell lung carcinoma (NSCLC). The...
Wed Apr 29, 2020 16:42
Wed Apr 29, 2020 16:40
Abstract The diagnosis of systemic lupus erythematosus (SLE) has undergone radical change after the development of serological techniques. The in vitro demonstration of lupus erythematosus (LE) cell has less significance for the diagnosis of SLE in the present scenario. Although over the years, the spontaneous in vivo occurrence of LE cell in numerous body fluids as an initial presentation of SLE has been documented. The report of the presence of the LE cell can not only aid in the further workup...
Wed Apr 29, 2020 16:34
Abstract Soft tissue tumors can be categorized molecularly into two categories: tumors which are known to have recurrent molecular alterations and tumors which do not have consistent recurrent molecular alterations or translocations. These “non‐translocation” associated sarcomas are clinically more aggressive than their more stable counterparts. However, recent advances in RNA sequencing have discovered recurrent novel fusions within the latter group, namely TERT‐TRIO fusions. Furthermore, a recent...
Thu Apr 30, 2020 12:08
Establishment and characterization of a MALT lymphoma cell line carrying an API2‐MALT1 translocation
Abstract MALT lymphomas with API2(BIRC3)‐MALT1 translocation usually have an indolent clinical course and rarely transform into aggressive lymphoma, and there have been no lymphoma cell lines carrying API2‐MALT1 translocation reported to date. We established a novel lymphoma cell line named BMA19, carrying the API2‐MALT1 translocation from a patient with histologic transformation of intestinal MALT lymphoma. The cells were suggested to carry API2‐MALT1 and MYC‐IGH translocations by chromosomal...
Wed Apr 29, 2020 19:21
Abstract Background Incidence of oropharyngeal cancer (OPC) is expected to increase but its health care cost is unknown. The purpose for this study was to estimate the phase‐specific lifetime health care costs of OPC for commercially insured individuals in the United States. Methods We used the Truven MarketScan Commercial Claims and Encounter Database to identify our patient population. Cox survival analysis was used to estimate patients' monthly survival probabilities. We determined...
Sat May 02, 2020 15:54
Abstract In India, oral cancer is the most common head and neck cancer (HNC) in men in India, mainly due to the consumption of smoked and smokeless tobacco. During the current pandemic, delaying surgery for even 1‐2 months may lead to more extensive surgery or inoperability, when only supportive care can be provided. Being semi‐emergent in nature, treatment for these patients is currently on hold or delayed in most centres across the country. This study was conducted to assess the impact of COVID‐19...
Fri May 01, 2020 21:22
Abstract The 2019 novel coronavirus disease (COVID‐19) pandemic has been spreading worldwide at an alarming rate. Healthcare workers have been confronted with the challenge of not only treating patients with the virus, but also managing the disruption of healthcare services caused by COVID‐19. In anticipation of outbreak, clinic sessions and operation theatre lists have been actively cut back since February 2020 to reduce hospital admissions and clinic attendances. This has severely disrupted healthcare...
Fri May 01, 2020 21:07
Abstract Background The COVID‐19 pandemic has raised concern of transmission of infectious organisms through aerosols formation in endonasal and transoral surgery. Methods Retrospective review. We introduce the Negative‐Pressure Otolaryngology Viral Isolation Drape (NOVID) system to reduce the risk of aerosol. NOVID consists of a plastic drape suspended above the patient's head and surgical field with a smoke evacuator suction placed inside the chamber. Results Four patients...
Fri May 01, 2020 15:59
Abstract With the arrival of the coronavirus disease (SARS‐CoV‐2) in the United States, care practice paradigms have drastically changed. Data from China suggest that the new virus poses additional risks as case fatality of patients with cancer was higher at 5.6% compared to 2.3% of the general population. There are three proposed major strategies to address care for patients with cancer in this SARS‐CoV‐2 pandemic with postponing treatment for those with stable cancer, increasing personal protection...
Sat May 02, 2020 15:55
Abstract Background This study describes a novel approach in reducing SARS‐CoV‐2 transmission during tracheostomy. Methods Five patients underwent tracheostomy between April 1, 2020 and April 17, 2020. A clear and sterile plastic drape was used as an additional physical barrier against droplets and aerosols. Operative diagnosis; droplet count and distribution on plastic sheet and face shields were documented. Results Tracheostomy was performed for patients with carcinoma...
Fri May 01, 2020 15:33
Abstract Introduction The COVID‐19 pandemic has raised controversies regarding safe and effective care of head and neck cancer patients. It is unknown how much the pandemic has changed surgeon practice. Methods A questionnaire was distributed to head and neck surgeons assessing opinions related to treatment and concerns for the safety of patients, self, family, and staff. Results A total of 67 head and neck surgeons responded during the study period. Surgeons continued...
Fri May 01, 2020 14:59
Abstract The novel coronavirus disease 2019 (COVID‐19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and was declared a pandemic in March 2020. A plethora of respiratory sampling methods for SARS‐CoV‐2 viral detection has been used and in the current evolving situation, there is no international consensus on the recommended method of respiratory sampling for diagnosis. Otolaryngologists deal intimately with the upper respiratory tract and a clear understanding of...
Fri May 01, 2020 14:44
Abstract Background To show how to safely perform nasopharyngeal and / or oropharyngeal swabs for 2019‐Novel Coronavirus. Methods The video describes in detail the dressing and undressing procedures of health personnel, with the appropriate personal protective equipment. Technical notes for the execution of the nasopharyngeal and oropharyngeal swab are also provided, to avoid sampling errors. Results The undressing phase is the procedure with the highest risk of self‐contamination...
Fri May 01, 2020 14:43
ABSTRACT BACKGROUND Coronavirus has serially overtaken our metropolitan hospitals. At peak, patients with acute respiratory distress syndrome may outnumber mechanical ventilators. In our Miami hospital system COVID‐19 cases have multiplied for 4 weeks and elective surgery has been suspended. METHODS An otolaryngologic triage committee was created to appropriately allocate resources to patients. Hospital ethicists provided support. Our tumor conference screened patients for non‐surgical...
Fri May 01, 2020 14:23
Abstract Background Chemosensitive disorders are very frequent in the early stages of COVID‐19 and in paucisymptomatic cases. These patients are typically placed in home quarantine. This study has the aim of validating a new olfactory and gustatory objective evaluation test in these patients. Methods Thirty‐three home‐quarantined COVID‐19 patients have undergone a self‐administered chemosensitive test the day before the control swab. On this occasion, the patients underwent operator‐administered...
Fri May 01, 2020 13:34
Abstract Background Patients with head and neck cancer (HNC) are at risk for limited healthcare access. Methods Individuals reporting a history of cancer were identified from the Medical Expenditure Panel Survey, an annual assessment of the nation's health. Access to care variables were compared between “HNC” and “other cancer” using multivariable methods and stratified by age 65. Results From 1998 to 2015, 420 patients with HNC and 14 468 with other cancers completed the...
Thu Apr 30, 2020 22:36
Abstract Performing a proper nasal and oropharyngeal swab procedure is essential in the screening of COVID‐19 infection. The video illustration of nasal and oropharyngeal swab is presented (Video #hed26212-supitem-0001S1). To correctly perform the nasopharyngeal swab, the patient must be seated comfortably with the back of their head against the headrest. The swab is inserted in the nose horizontally, along an imaginary line between the nostril and the ear. Oropharyngeal sampling is easier to perform....
Thu Apr 30, 2020 15:27
Abstract Background Radiation‐associated dysphagia (RAD) is highly prevalent in head and neck cancer (HNC) patients, with insufficient tongue strength (TS) as a characteristic of this disabling complication. The effects of tongue‐strengthening exercises (TSE) on TS, swallowing, and quality of life (QoL) have not been studied in this population. Methods A prospective phase 2 study using an 8 weeks during TSE protocol was carried out in 15 patients with chronic RAD. Outcome parameters...
Thu Apr 30, 2020 15:09
Abstract Background Otolaryngologists represent a subset of healthcare workers uniquely vulnerable to COVID‐19 transmission. Given the segmentation of extant guidelines concerning precautions and protective equipment for SARS‐CoV2, we aimed to provide consolidated recommendations regarding appropriate personal protective equipment (PPE) in head neck surgery during the COVID‐19 era. Methods Guidelines published by international and United States governing bodies were reviewed in conjunction...
Wed Apr 29, 2020 19:18
Abstract As this ever‐evolving pandemic lays itself, more of its impact is being understood. Until recently, most guidelines were reported to aid in managing and treating suspected or confirmed cases. Research institutions around the world are responding with a sense of confusion. Some are continuing routinely, especially those who are overseeing clinical trials that could offer life‐saving therapies, particularly against the novel coronavirus. Since research must continue even in the face of a...
Sat May 02, 2020 15:52
Abstract The global pandemic of 2019 Novel Coronavirus Disease (COVID‐19) has tremendously altered routine medical service provision and imposed unprecedented challenges to the healthcare system. This impacts patients with dysphagia complications caused by head and neck cancers. As this pandemic of COVID‐19 may last longer than SARS in 2003, a practical workflow for managing dysphagia is crucial to ensure a safe and efficient practice to patients and healthcare personnel. This document provides...
Wed Apr 29, 2020 19:16
Abstract Background The United States now has the highest death toll due to COVID‐19. Many otolaryngology procedures, including laryngoscopy, bronchoscopy, and esophagoscopy, place otolaryngologists at increased risk of coronavirus transmission due to close contact with respiratory droplets and aerosolization from the procedure. The aim of this study is to provide an overview of guidelines on how to perform these procedures during the coronavirus pandemic. Methods Literature review...
Fri May 01, 2020 15:44
Abstract Background The global COVID‐19 pandemic brings new challenges to otolaryngology resident education. Surgical volume and clinic visits are curtailed, personal protective equipment for operating room participation is restricted, and the risk of COVID‐19 disease transmission during heretofore routine patient care is the new norm. Methods We describe a small‐team “cohorting” protocol including guidelines for faculty and resident in common clinical scenarios with attention paid...
Wed Apr 29, 2020 19:15
Abstract As an aerosol and droplets generating procedure, tracheostomy increases contamination risks for health workers in the coronavirus disease context. To preserve the health care system capacity and to limit virus cross‐transmission, protecting caregivers against coronavirus infection is of critical importance. We report the use of external fixator equipment to set up a physical interface between the patient's neck and the caregiver performing a tracheostomy in COVID‐19 patients. Once the...
Wed Apr 29, 2020 16:15
Abstract Typical surgical treatment for invasive thyroid carcinoma at the level of the cricoid substantially reduces surrounding cartilaginous support and risks damage to the recurrent laryngeal nerve (RLN). We present a novel tracheal reconstructive technique that minimizes this injury risk. A 72‐year‐old man with recurrent invasive thyroid carcinoma underwent cricotracheal resection and reconstruction using a stair‐step approach. Diseased cartilage was removed by a left hemitracheal and hemicricoid...
Wed Apr 29, 2020 16:12
Abstract Background Telehealth postoperative visits are an attractive strategy to minimize exposure, especially during the SARS‐CoV‐2 (COVID‐19) pandemic. The use of a surgical drain often prevents this minimal‐exposure approach in that patients return to the outpatient clinic for drain removal. Methods and Results Following unilateral neck dissection, the customary closed‐suction drain was replaced with a self‐removing, passive drain dressing to facilitate same‐day discharge and...
Wed Apr 29, 2020 15:44
Abstract We present data from patients with advanced biliary tract cancer (BTC) receiving pembrolizumab in the KEYNOTE‐158 (NCT02628067; phase 2) and KEYNOTE‐028 (NCT02054806; phase 1b) studies. Eligible patients aged ≥18 years from both studies had histologically/cytologically confirmed incurable BTC that progressed after standard treatment regimen(s), measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, Eastern Cooperative Oncology Group performance status...
Sat May 02, 2020 16:59
Abstract Immunotherapy targeting programmed cell death‐1 (PD‐1) has become a standard pharmacological therapy. Although tumor mutation burden level was reported to depend on the tumor location in non‐small cell lung cancer (NSCLC), predictive impact of the tumor location on the response to anti‐PD‐1 therapy is unknown. Two hundred and seventeen advanced or recurrent NSCLC patients treated with anti‐PD‐1 therapy at Kyushu University Hospital and National Hospital Organization Kyushu Cancer Center...
Fri May 01, 2020 14:04
Abstract Smoking and second‐hand smoke (SHS) exposure have been recently linked to a higher risk of breast cancer in women. The aim of this work is to estimate the number of deaths and disability‐adjusted life years (DALYs) from breast cancer attributable to these two risk factors in the European Union (EU‐28) in 2017. The comparative risk assessment method was used. Data on prevalence of smoking and SHS exposure were extracted from the Eurobarometer surveys, relative risks from a recent meta‐analysis,...
Sat May 02, 2020 16:32
Abstract We examined whether automated visual evaluation (AVE), a deep learning computer application for cervical cancer screening, can be used on cervix images taken by a contemporary smartphone camera. A large number of cervix images acquired by the commercial MobileODT EVA system® were filtered for acceptable visual quality and then 7,587 filtered images from 3,221 women were annotated by a group of gynecologic oncologists (so the gold standard is expert impression, not histopathology). We tested...
Thu Apr 30, 2020 20:26
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