On histopathology there was an intense lymphocytic, perineural infiltration
and focal granulomatous inflammation, around the nerve.
Moreover, any diagnostic report should be also accompanied by further well-known microstaging attributes, such as Clark level, mitotic count, lymphovascular invasion, perineural infiltration
, ulceration, satellitosis, tumor infiltrating lymphocytes, and, if available, sentinel lymph node status (10, 11).
These findings are in line with a study of Tabata and coworkers who reported an association of perineural infiltration
with higher T and UICC tumor stages, respectively (19).
Further, vascular invasion was diagnosed in 70 patients (43.75%), and perineural infiltration was present in 106 patients (65.03%).
In the univariate survival analysis, pT stage (p=0.020 for pT3 and p=0.014 for pT4a), presence of neck metastases (p=0.015), LNR (p=0.006), ENE (p=0.001), perineural infiltration (p=0.007), and vascular invasion (p=0.014) were statistically significant (Table 3).
The histological examinations of the tumor confirmed tongue squamous cell carcinoma, moderate differentiation, keratinization, with large areas of ulcers, intense pleomorphism, many mitosis, perineural infiltration
, [pT.sub.3][N.sub.x] G2.
In malignant diseases, the paralysis of the facial nerve may be due to the perineural infiltration
of the temporal bone or facial nerve, central nervous system lymphoma or invasion to the meninx, infection and hemorrhage around the facial nerve, chemotherapy associated toxicity to the nerve and reactivation of the latent viral infection.
Several histopathologic features of periampullary adenocarcinoma tumors correlate with survival following resection, including lymph node (LN) status, perineural infiltration
, lymphovascular invasion, and lymph node ratio (LNR).
Secondary CPCs were detected more frequently in patients with positive margins, extracapsular extension, and vascular and lymphatic infiltration but not with perineural infiltration
by lymphocytes was seen in 1 (33.3%) case.
Nerve twigs within the biopsy specimen (figure 2, B) indicated perineural infiltration
by the tumor.
The association between histopathologic findings and persistent abdominal pain in CP has been studied extensively, but the pathogenic mechanism for the pain has not been defined.[4,10,23] Perineural scarring and inflammation have been described in both painful and painless CP.[4,10,23] Previous studies have shown an increase in the number and diameter of the pancreatic nerve fibers in CP, as well as perineural infiltration
by T lymphocytes, suggesting a cell-mediated cytotoxic mechanism for the neural alteration. Di Sebastiano et al proposed that the lymphocytic infiltration of pancreatic nerves is one of the pathogenic factors for the generation of pain.