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Ngo Pambe CJ, Onana Y, Essame Oyono JL, Ongolo Zogo P, Mendimi JM. [Primary tuberculosis of the cavum: An unusual diagnosis]. Ann Pathol 2023; 43:483-486. [PMID: 36948994 DOI: 10.1016/j.annpat.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/13/2023] [Accepted: 03/02/2023] [Indexed: 03/24/2023]
Abstract
Primary tuberculosis of the cavum is a rare entity. It can occur at any age, especially between the second and ninth decade. We report the case of a 17-years-old patient with nasal obstruction and left laterocervical adenomegaly. A cervico-facial CT scan showed a suspicious looking tumor process of the nasopharynx. Histological analysis of the biopsies taken showed chronic granulomatous inflammation with necrosis and the absence of tuberculosis lesions in the usual sites, especially the lungs, led to the diagnosis of primary tuberculosis of the cavum. There was a good evolution on antituberculosis drugs. This unusual location can be a source of difficulties and delay in diagnosis, especially because of the clinical presentation, which suggests a nasopharyngeal tumour. In developing countries, where this disease remains relatively endemic, cross-sectional imaging techniques and histopathological analysis are of great interest for the management of patients.
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Affiliation(s)
- Christiane Judith Ngo Pambe
- Département des sciences morphologiques et d'anatomie pathologique, faculté de médecine et des sciences biomédicales, université de Garoua, 317 Garoua, Cameroun.
| | - Yannick Onana
- Département de radiologie et d'imagerie médicale, faculté de médecine et des sciences biomédicales, université de Garoua, 317 Garoua, Cameroun
| | - Jean-Louis Essame Oyono
- Département des sciences morphologiques et d'anatomie pathologique, faculté de médecine et des Sciences biomédicales, université de Yaoundé I, 1634 Yaoundé, Cameroun
| | - Pierre Ongolo Zogo
- Département de radiologie et d'imagerie médicale, faculté de médecine et des sciences biomédicales, université de Yaoundé I, 1634 Yaoundé, Cameroun
| | - Joseph Marie Mendimi
- Département des sciences morphologiques et d'anatomie pathologique, faculté de médecine et des Sciences biomédicales, université de Yaoundé I, 1634 Yaoundé, Cameroun
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Tsai MH, Liao SL, Chiu CY, Shih HJ, Hua MC, Yao TC, Lai SH, Yeh KW, Chen LC, Chang YJ, Huang JL. Longitudinal investigation of nasopharyngeal pneumococcal carriage in early childhood: The PATCH birth cohort study. PLoS One 2020; 15:e0237871. [PMID: 32817720 PMCID: PMC7446878 DOI: 10.1371/journal.pone.0237871] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/04/2020] [Indexed: 01/15/2023] Open
Abstract
Streptococcus pneumoniae is a common cause of infectious diseases such as pneumonia and sepsis. Its colonization is thought to be the first step in the development of invasive pneumococcal diseases. This study aimed to investigate pneumococcal colonization patterns in early childhood. A longitudinal birth cohort study was conducted for investigating nasopharyngeal colonized pneumococci at 1, 6, 12, 18, 24, and 36 months of age, particularly focusing on the serotype distribution and antimicrobial susceptibilities. Pneumococcal conjugate vaccine (PCV) effect on nasopharyngeal colonization was also assessed. During 2013-2017, 855 infants were enrolled and a total of 107 isolates were recovered from 95 infants during the first three years of life. In this period, the prevalence of pneumococcal colonization increased, with values ranging from 0.2% (2/834) at 1 month of age to 5.9% (19/323) at 36 months of age. The investigation of serotype revealed that 81.1% (73/90) belonged to the non-PCV13 serotypes-23A, 15A, 15C, and 15B. Moreover, PCV13 serotypes significantly decreased during 2014-2015, when routine PCV13 vaccination was initiated in Taiwan. PCV13 introduction may lead to the reduction in the rates of pneumococcal isolates resistant (R) to penicillin. Under conditional PCV13 vaccination, pneumococcal isolates primarily belonged to non-PCV13 serotypes. This non-PCV13 serotype replacement exhibited lower rates of penicillin R isolates, suggesting that PCV13 administration may reduce the antibiotic-nonsusceptible pneumococcal disease burden and antibiotic use.
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Affiliation(s)
- Ming-Han Tsai
- Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- * E-mail: (JLH); (MHT)
| | - Sui-Ling Liao
- Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chih-Yung Chiu
- Chang Gung University College of Medicine, Taoyuan, Taiwan
- Division of Pulmonology, Department of Pediatrics, Chang Gung Children’s Hospital, Taoyuan, Taiwan
| | - Hsiang-Ju Shih
- Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Man-Chin Hua
- Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Tsung-Chieh Yao
- Chang Gung University College of Medicine, Taoyuan, Taiwan
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Children’s Hospital, Taoyuan, Taiwan
| | - Shen-Hao Lai
- Chang Gung University College of Medicine, Taoyuan, Taiwan
- Division of Pulmonology, Department of Pediatrics, Chang Gung Children’s Hospital, Taoyuan, Taiwan
| | - Kuo-Wei Yeh
- Chang Gung University College of Medicine, Taoyuan, Taiwan
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Children’s Hospital, Taoyuan, Taiwan
| | - Li-Chen Chen
- Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Pediatrics, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, New Taipei, Taiwan
| | - Yi-Jung Chang
- Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Pediatrics, Chang Gung Children’s Hospital, Taoyuan, Taiwan
| | - Jing-Long Huang
- Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Pediatrics, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, New Taipei, Taiwan
- * E-mail: (JLH); (MHT)
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Abstract
RATIONALE Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive hematologic malignancy. This disease almost always presents with cutaneous involvement. PATIENT CONCERNS The 1st patient was a 16-year-old girl who presented with recurrent epistaxis. The 2nd patient was a 17-year-old female who presented with nasal obstruction and voice change for a month. DIAGNOSES In the 1st patient, sinonasal computed tomography (CT) revealed a 2.9-cm sized, polypoid mass in the nasal cavity. In the 2nd patient, CT scans revealed a large enhancing nasopharyngeal mass involving adenoid and several small indeterminate lymph nodes at the neck. Cutaneous examination was unremarkable for either patient. Biopsy of these 2 masses and bone marrow biopsy were performed. Histologic diagnosis of the 2 cases was BPDCN. INTERVENTIONS Both patients were treated with induction chemotherapy and received allogenic peripheral blood stem-cell transplant. OUTCOMES No relapse was observed in the 2 patients for 14 and 11 months, respectively, after transplantation. Interestingly, they had no skin lesions at initial diagnosis or during the course of their illness. LESSONS We 1st identified nasal cavity as an unusual site of BPDCN. BPDCN should be considered in differential diagnosis of blastic leukemia with an undifferentiated and ambiguous immunophenotype despite the absence of skin lesions.
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Affiliation(s)
- Seung Eun Lee
- Department of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul
| | - Ha Young Park
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan
| | - Dohee Kwon
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine
| | - Yoon Kyung Jeon
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine
- Cancer Research Institute, Seoul National University
| | - Wook Youn Kim
- Department of Pathology, Konkuk University School of Medicine, Seoul, Korea
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Cranford J, Kadakia S, Berzofsky C. Palatopharyngoplasty for treatment of nasopharyngeal stenosis secondary to extra-laryngeal tuberculosis. Am J Otolaryngol 2016; 37:559-562. [PMID: 27448412 DOI: 10.1016/j.amjoto.2016.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 06/12/2016] [Accepted: 06/28/2016] [Indexed: 11/20/2022]
Abstract
Nasopharyngeal stenosis is a rare sequela of extra-laryngeal tuberculosis that can adversely impact the quality of life of afflicted patients. Relying solely on the oropharyngeal airway, patients often complain of inspiratory dryness and decreased sensation of airflow as the nasal mucosa and turbinate complex is entirely excluded from the breathing mechanism. Often times, the oropharyngeal inlet can be narrowed as well, limiting the air flow through the oropharyngeal airway. In those circumstances, patients often require tracheostomy for establishment of a reliable airway. We present the unique case of a previously tracheotomized patient with nasopharyngeal stenosis secondary to tuberculosis successfully treated with a modified palatopharyngoplasty to reestablish a patent naso-oropharyngeal airway. During the follow-up period, the patient was decannulated and highly satisfied with his respiratory status. Although rare and more commonly used in the treatment of sleep apnea, palatopharyngoplasty can be a viable option for the treatment of naso-oropharyngeal stenosis and should be kept in the armamentarium of reconstructive craniofacial surgeons.
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Affiliation(s)
- Jeffrey Cranford
- Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, USA.
| | - Sameep Kadakia
- Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, USA.
| | - Craig Berzofsky
- Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, USA.
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Affiliation(s)
- Chun-ta Liao
- Department of Otorhinolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan
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Adhami M, Coste A, Escabasse V, Chalumeau F. The inferior turbinate, an unusual site for a choanal polyp: Two case reports and a review of the literature. Ear Nose Throat J 2016; 95:E1-E4. [PMID: 27434478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Choanal polyps are unilateral sinonasal lesions that are classified according to their site of origin. The aim of this report is to highlight an unusual form of choanal polyp and to present a thorough literature review. To the best of our knowledge, only 6 cases of a choanal polyp originating in the inferior turbinate have been previously reported in the literature. We describe 2 new cases. One patient was a 14-year-old boy who presented with nasal obstruction, facial headaches, and obstructive sleep apnea; the other patient was a 70-year-old man who presented with right mucopurulent rhinorrhea and right nasal obstruction. In both cases, nasal fibroscopy detected a polyp arising from the right inferior turbinate and extending toward the right choana. Endoscopic sinus surgery was performed in both cases to ensure a complete excision. Cases of choanal polyp arising from the inferior, middle, and superior turbinates and the septum are rare, although some appear to be more common than is generally believed, especially in the pediatric population. We therefore recommend that unusual forms of choanal polyp be included in the differential diagnosis of a unilateral sinonasal mass.
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Affiliation(s)
- Maya Adhami
- Corresponding author: Maya Adhami, MD, Saint George Hospital University Medical Center, Mar Mikhael, Beirut, Lebanon. Email From the Department of Otorhinolaryngology, Saint George Hospital University Medical Center, Beirut, Lebanon (Dr. Adhami); and the Department of Otorhinolaryngology-Head and Neck Surgery, Centre Hospitalier Intercommunal, Créteil, France (Prof. Coste, Dr. Escabasse, and Dr. Chalumeau). The cases described in this article occurred at Centre Hospitalier Intercommunal
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Tajima S, Ohkubo A, Yoshida M, Koda K, Nameki I. Melanotic oncocytic metaplasia of the nasopharynx: a case report with a focus on immunohistochemical analyses and literature review. Int J Clin Exp Pathol 2015; 8:2103-2110. [PMID: 25973111 PMCID: PMC4396311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 01/28/2015] [Indexed: 06/04/2023]
Abstract
Melanotic oncocytic metaplasia (MOM) of the nasopharynx is an extremely rare lesion, with only 21 cases reported in English literature to date. MOM typically occurs near the Eustachian tube opening in Asian men in their 60 s to 70 s. Here, we present a case of MOM in a 57-year-old Japanese man who is a heavy smoker. The patient did not have complaints; MOM was diagnosed incidentally as 4 flat elevated lesions with brown to black discoloration, ranging from 2 to 3 mm in maximal diameter, were found in the right torus tubarius. On suspecting melanoma, the largest lesion was biopsied. Microscopic examination identified both oncocytic metaplasia and melanin pigmentation of the epithelium in the same gland. Upon immunohistochemical examination, melanocytes displayed reactivity for 3 out of 4 melanocytic markers; immunopositivity for S-100 protein, Melan-A, and MITF and immunonegativity for HMB-45 was observed. Normal melanocytes in the nearby surface respiratory epithelium displayed the same pattern of immunoreactivity. Immunopositivity for S-100 protein and immunonegativity for HMB-45 have been previously reported in MOM. Reduction of stimulation of melanocytes in a longstanding lesion like MOM may explain the immunonegativity for HMB-45. S-100 protein, in conjunction with more specific marker for melanocytes, Melan-A or MITF, could prove the definite presence of melanocytes in this case of MOM. As it has been shown by previous reports that MOM pursues a benign course, it will be sufficient to follow up the patients regularly for the remaining 3 lesions.
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Affiliation(s)
- Shogo Tajima
- Department of Pathology, Graduate School of Medicine, The University of TokyoTokyo, Japan
- Department of Pathology, Fujieda Municipal General HospitalShizuoka, Japan
| | - Aki Ohkubo
- Department of Otolaryngology, Fujieda Municipal General HospitalShizuoka, Japan
| | - Matsumi Yoshida
- Department of Otolaryngology, Fujieda Municipal General HospitalShizuoka, Japan
| | - Kenji Koda
- Department of Pathology, Fujieda Municipal General HospitalShizuoka, Japan
| | - Ichirota Nameki
- Department of Otolaryngology, Fujieda Municipal General HospitalShizuoka, Japan
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Beniova SN, Taranova SV, Babko SV. [Specific clinical and immunological features of chronic diseases of the nasal-associated lymphoid tissue in the children]. Vestn Otorinolaringol 2014:36-38. [PMID: 25377675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The objective of the present work was to study the structure, clinical, and immunological features of various etiological variants of chronic diseases of the nasal-associated lymphoid tissue in the children. A total of 142 children at the age from 3 to 7 years presenting with this pathological condition were available for the observation. The study revealed differences in the clinical course of the disease and the cytokine response (IL-6, Ril-6, TNF, sYNFR55, sTNFR75) at the local and systemic levels for different pathogens (S. aureus, S. pneumoniae, S. pyrogenes).
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Cengiz AB, Cömert E, Onursever A, Demirel BB, Tunçel U. Respiratory epithelial adenomatoid hamartoma (REAH) of the nasopharynx with high 18F-FDG uptake on PET/CT. B-ENT 2014; 10:227-230. [PMID: 25675670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
Respiratory epithelial adenomatoid hamartoma (REAH) is a rare benign non-neoplastic sinonasal lesion that usually presents in the nasal cavity, paranasal sinuses, or olfactory cleft. We report a case of nasopharynx REAH mimicking a malignant tumour with incidental high 18-FDG uptake in a patient with colon cancer. Less than five similar cases have been reported to date, and this is the first case of REAH to show high uptake on PET/CT scans. Although hamartoma arising from the nasopharynx region is very rare, it should be considered in the differential diagnosis because it is a benign lesion and complete surgical resection is curative.
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10
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Berkiten G, Kumral TL, Yildirim G, Uyar Y, Atar Y, Salturk Z. Eight years of clinical findings and biopsy results of nasopharyngeal pathologies in 1647 adult patients: a retrospective study. B-ENT 2014; 10:279-284. [PMID: 25654951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVES We performed an 8-year retrospective study to evaluate the presentation, clinical findings and nasopharyngeal biopsy results of adult nasopharyngeal pathologies. METHODOLOGY This study included 1647 patients (801 males and 846 females) admitted to outpatient clinics. All patients underwent a nasopharyngeal biopsy for a nasopharyngeal mass. In addition, a blind biopsy was taken if there was suspicion of nasopharyngeal carcinoma, even in the absence of a mass lesion. The pathological diagnoses were analysed on the basis of the age, sex and clinical presentation of the patients. RESULTS Patient age ranged between 18 and 85 years; the mean was 36 years. Patient age differed significantly between those with benign and malignant disease (p=0.000); the risk of malignancy increased with age. Benign disease was found in 97.4% of the patients. Reactive lymphoid hyperplasia was the most common condition; it was found in 92.71% of benign cases. Undifferentiated nasopharyngeal cancer was the most common malignant disease, being found in 82.95% of all nasopharyngeal malignancies and in 4.43% of all nasopharyngeal disease. The most common symptom was nasal obstruction. The other main symptoms were hearing loss and neck mass. Neck mass was associated with malignancy. CONCLUSIONS Benign disease of the nasopharynx is more common than malignant pathology in patients with a nasopharyngeal mass. Although adenoidal tissue undergoes regression in the adolescent period, this tissue may present as the chief cause of nasal obstruction in adults. Age and symptoms may predict malignant disease.
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11
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Xie S, Zhou Y. [Fixation of nasal cavity tube with anterior and posterior nares in treatment of upper retro-soft palate region airway adhesion]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2012; 26:801-802. [PMID: 23214320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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12
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Lin L, Wang SY, Wang J. [Extranodal Rosai-Dorfman disease of upper respiratory tract: a clinicopathologic study]. Zhonghua Bing Li Xue Za Zhi 2012; 41:11-15. [PMID: 22455843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To study the clinicopathologic features and differential diagnosis of extranodal Rosai-Dorfman disease (RDD) of the upper respiratory tract. METHODS The clinical, pathologic and immunohistochemical features of 10 cases of RDD were evaluated. RESULTS Among the 10 cases studied, there were 3 males and 7 females. The age of patients ranged from 20 to 61 years old (mean 38 years). The lesion arose in the nasal cavity (7 cases), nasopharynx (2 cases) or hard palate to trachea (1 case). Most of the patients presented with nasal obstruction, rhinorrhagia or tumor mass in the nasal/nasopharyngeal regions. CT scan often showed the presence of soft tissue lesion without bone destruction. Histologically, extranodal RDD was characterized by light-staining bands alternating with dark-staining bands. The light-staining bands were formed by aggregates of large round or polygonal histiocytes with emperipoiesis. The dark-staining bands were formed by abundant lymphoplasmacytic infiltrates. Immunohistochemical study showed that the histiocytes strongly expressed S-100 protein and partially expressed CD68. Six patients had no recurrence after surgical resection. CONCLUSIONS Extranodal RDD of the upper respiratory tract is a rare disorder of histiocytic proliferation, which usually involves the nasal cavity and paranasal sinuses. RDD can easily mimic rhinoscleroma, mainly due to the overlapping morphologic appearance. Immunohistochemical study is helpful in the differential diagnosis.
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MESH Headings
- Adult
- Antigens, CD/metabolism
- Antigens, Differentiation, Myelomonocytic/metabolism
- Diagnosis, Differential
- Female
- Follow-Up Studies
- Histiocytic Sarcoma/metabolism
- Histiocytic Sarcoma/pathology
- Histiocytosis, Langerhans-Cell/metabolism
- Histiocytosis, Langerhans-Cell/pathology
- Histiocytosis, Sinus/diagnostic imaging
- Histiocytosis, Sinus/metabolism
- Histiocytosis, Sinus/pathology
- Histiocytosis, Sinus/surgery
- Humans
- Male
- Middle Aged
- Nasal Cavity/pathology
- Nasopharyngeal Diseases/diagnostic imaging
- Nasopharyngeal Diseases/metabolism
- Nasopharyngeal Diseases/pathology
- Nasopharyngeal Diseases/surgery
- Neoplasms, Muscle Tissue/metabolism
- Neoplasms, Muscle Tissue/pathology
- Nose Diseases/diagnostic imaging
- Nose Diseases/metabolism
- Nose Diseases/pathology
- Nose Diseases/surgery
- S100 Proteins/metabolism
- Tomography, X-Ray Computed
- Young Adult
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Affiliation(s)
- Lan Lin
- Department of Pathology, Eye and Ear Nose Throat Hospital of Fudan University, Shanghai 200031, China.
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13
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Garetier M, Breton S, Conan-Charlet V, Pennaneach A, Garrigues F, Forlodou P, Marianowski R. [Heterotopic nasopharyngeal neuroglial tissue]. ACTA ACUST UNITED AC 2011; 92:722-4. [PMID: 21819914 DOI: 10.1016/j.jradio.2011.03.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 03/27/2011] [Accepted: 03/31/2011] [Indexed: 11/17/2022]
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Maślińska M, Legatowicz-Koprowska M, Przygodzka M. [Amyloidosis--diagnostic difficulties. A case report of localized amyloidosis]. Wiad Lek 2011; 64:202-207. [PMID: 22335145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Amyloidosis consists of a group of clinical disorders caused by extracellular deposition of insoluble protein fibrils which present beta pleated sheets configuration. Such structure makes fibrils resistant to proteolysis. Amyloidosis can be of acquired or hereditary origin. Amyloid deposits can accumulate in locally (localized amyloidosis) or simultaneously in many organs (systemic amyloidosis). Unclear pathogenesis and varied etiology result in particular diagnostic difficulties. Current article attempts to discuss this problem. Presented clinical case of a patient with the amyloid tumor in nosopharynx and positive staining for amyloid in abdominal fat tissue biopsy serves as an example of the diagnostical proceedings in amyloidosis. Congo red staining and red-green birefringence under cross--polarized light of histological specimens still remains a standard procedure in amyloidosis diagnostics. Such methods, however, do not allow to determine the type of the precursor protein, and thus the type of amyloidosis. Thus immunohistochemical tests constitute the next diagnostic phase. Currently, expanded diagnostic capabilities of SAP scintigraphy and of DNA sequencing (establishing transthyretin and apolipoprotein mutations) are also available. Research is carried out on the usefulness of fluorescence spectroscopy in the diagnosis of secondary amyloidosis. Mass spectrometry is used in combination with two-dimensional gel electrophoresis techique for the analysis of protein profiles.
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Affiliation(s)
- Maria Maślińska
- Oddział Wczesnej Diagnostyki Zapalenia Stawów, Instytut Reumatologii im. prof. dr hab. med. Eleonory Reicher w Warszawie
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15
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Zhang QQ, Wang Q, Chen XM. [Type of adenoidal hypertrophy by nasal endoscopic and clinical significance]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010; 45:859-860. [PMID: 21176580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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16
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Abstract
A mass in the nasopharynx often implies a malignancy in adults, particularly in the endemic areas of Epstein-Barr virus-associated undifferentiated carcinoma. We report an 86-year-old male patient who presented to our rhinologic outpatient department with postnasal drip for several years, with no other associated nasal symptoms. Physical examination with nasal endoscopy found a prominent bulge in the nasopharynx. Pathological examination of the biopsied specimens identified features consistent with amyloidosis. Magnetic resonance imaging demonstrated an enhanced soft-tissue mass localized to the nasopharyngeal region. We excluded the possibility of a partial representation of a potential systemic amyloidosis. Regular follow-up including nasal endoscopy was undertaken. Over 3 years of observation, the disease process remained silent. Here, the clinical presentation, diagnosis and treatment options of this rare entity are discussed.
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Affiliation(s)
- Yen-Sheng Chen
- Department of Otolaryngology, Taipei Veterans General Hospital, 201 Section 2 Shih-Pai Road, Taipei, Taiwan, R.O.C
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Li Y, Lu ZH, Lü W, Chen J. Images for diagnosis. Melanotic oncocytic metaplasia of nasopharynx: a case report with review. Chin Med J (Engl) 2010; 123:1230-1232. [PMID: 20529571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Affiliation(s)
- Yuan Li
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
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Beugre-Kouassi AML, Beugre JB, Tanon-Anoh MJ, Kouassi M, Hoballah N, Djaha K. [Cephalometric characteristics of black African children 3-6 years of age with nasal obstruction]. Odontostomatol Trop 2009; 32:43-52. [PMID: 20441128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To determine the cephalometric craniofacial characteristic of the child with chronic rhinopharyngeal obstruction. MATERIAL AND METHODS It is about a comparative cross-sectional study with etiologic aiming including children of the 2 sexes, old from 3 to 6 years. The pathological subjects are represented by those presenting a chronic rhinopharyngeal obstruction due to the presence of hypertrophied tonsils (n = 29) and the "normal" subjects, those without any rhinopharyngeal obstruction (n = 30). Lateral cephalometric radiographs were obtained for each subject. The conventional landmarks were determined with the subject's head in neutral position. The two groups underwent cephalometric measurements. The cephalometric analysis was made starting from conventional landmarks resulting from soft tissues and osseous structures. Various statistical tests (test t of student, test of Kruskal Wallis, test of Mann-Whitney) were used for the exploitation of the cephalometric data. RESULTS On the skeletal level, the length of the posterior cranial base was shorter at the pathological subjects than at the healthy subjects. Concerning the mandible, the height of the ramus and the length of the mandibular corpus are also weaker at the pathological subjects than at the witnesses. The hyoid bone is further away from the 3rd cervical vertebra and the craniocervical angle is more open at the pathological subjects, representing a modification of the slope of the cervical column. On the level of the rhinopharyngeal space, the average distances from the posterior nasal spine at the posterior edge of the rhinopharyngeal space and between the posterior nasal spine and the posterior base of the base of cranium are respectively of 19,43 +/- 4,78 mm and 37,56 +/- 2,95 mm. These measurements are not significantly different from those described in the literature. CONCLUSION Our study highlighted skeletal modifications in children presenting a rhinopharyngeal obstruction. Even if they do not justify all the symptoms met, these modifications can represent a readjustment of the pharyngeal corridor aiming at facilitating the flow of airflow.
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Affiliation(s)
- A M L Beugre-Kouassi
- Sce d'Orthopédie dento-faciale, U.F.R d'odonto-stomatologie d'Abidjan, Cocody, Côte d'Ivoire
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Taş A, Yağiz R, Koçyiğit M, Karasalihoğlu AR. Primary nasopharyngeal tuberculosis. Kulak Burun Bogaz Ihtis Derg 2009; 19:109-111. [PMID: 19796011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Primary nasopharyneal tuberculosis is a rare disease which is commonly present with cervical lymphadenopathy. It is hard to differenciate the diagnosis of tuberculosis from nasopharyngeal carcinoma. Histologic and bacteriologic evaluation is required for diagnosis. A male patient at the age of nineteen applied to our clinic with the complaints of a mass in the neck, congestion in the nose, night sweating and weight loss. Clinical presentation of the patient was similar to that of a malignant tumor of the nasopharynx. Histologic and bacteriologic study supported the diagnosis of tuberculosis. After anti-tuberculosis therapy, the complaints of the patient regressed. We present a nasopharyngeal tuberculosis case in this study.
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Affiliation(s)
- Abdullah Taş
- Department of Otolaryngology, Medicine Faculty of Trakya University, Edirne, Turkey.
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20
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Buadze G, Khechinashvili S, Beridze M, Khundadze I, Alpaidze M. Dopplerographic correlates of headaches accompanying the chronic nasal and nasopharyngeal pathology. Georgian Med News 2009:46-49. [PMID: 19276469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The present study aimed at research of cerebral blood flow in patients with chronic nasal and nasopharyngeal pathology with accompanying headaches before and after appropriate treatment. One hundred and six patients with chronic nasal and nasopharyngeal pathology, aged from 6 to 75 years, 57 male and 49 female have been investigated. According to the type of nasal and nasopharyngeal pathology patients were classified in 5 groups, and were divided in three age categories: 6 -18 years (39 patients), 19- 65 years (38 patients), 66-75 years (29 patients). Headaches were estimated by neurologist before appropriate surgical and conservative treatment, after treatment and 6 months later. Cerebral blood flow was studied before treatment, after treatment and 6 months later by means of Transcranial Dopplerography. Control consisted of 30 age-matched healthy persons. Chronic headaches were established in 63 patients (59%). In all age categories the mean blood velocity in middle cerebral artery, anterior cerebral artery, basilar artery was significantly increased against control (p<0.05), and pulsation index (PI) found to be decreased compared to control. After treatment blood flow velocity in the middle cerebral artery, anterior cerebral artery and in basilar artery in all age groups did not differ significantly from control (p<0.5), and PI was significantly elevated against previous data (p<0.05). Cephalic pains disappeared in 75% of treated patients and 25% noted the significant decrease in pain intensity and frequency. Treatment of chronic nasal and nasopharyngeal pathology can prevent the certain kind of cephalic pains, and improve the clinical course of accompanying headaches.
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Affiliation(s)
- G Buadze
- Tbilisi State Medical University Clinic
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21
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Holsinger JM, Magro C, Allen C, Powell D, Agrawal A. Eosinophilic angiocentric fibrosis. J Otolaryngol Head Neck Surg 2008; 37:E155-E158. [PMID: 19128662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
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22
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Oryan A, Valinezhad A, Moraveji M. Prevalence and pathology of camel nasal myiasis in eastern areas of Iran. Trop Biomed 2008; 25:30-36. [PMID: 18600202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Camel botfly, Cephalopina titillator, causes severe economic losses to the camel industry in many camel-producing areas of the world. A total of 1328 camels, of different age groups and of both sexes, slaughtered at Mashhad Slaughterhouse, Khorasan Razavi Province, eastern Iran were inspected for infestation with larvae of C. titillator. After slaughtering, the head was dissected and grossly inspected for presence of C. titillator larvae and other gross abnormalities. Seven hundred and seventy one camels (58.1%) were infested with this larvae and the rate of infestation was significantly greater in the colder months (69.8%) compared to those of warmer ones (36.2%) and in males (65.0%) compared to those of the female camels (45.60%). The prevalence rate was lower in camels younger than 2 years old (39.8%) compared to those of 2-6 (61.5%) and over 6 years old (62.8%). Proper tissue sections from nasal cavity, pharynx, turbinates and frontal sinuses of 30 infested and 10 uninfested camels processed routinely for histopathological studies. The mucous membranes of the nasopharynx and frontal sinuses of the heavily infested camels were congested, swollen, edematous, occasionally haemorrhagic and infrequently occupied by copious amounts of muco-fibrinous exudates. Dark brown or black nodules were seen in the mucous membrane of these structures. The main histopathologic changes were desquamation, hydropic degeneration and hyperplasia of the mucosal epithelium with focal or diffused infiltration of lymphocytes, plasma cells, macrophages, eosinophils and fibroblasts in the mucosa and submucosal layers. Hyperemia of the blood vessels of the nasopharyngeal wall, goblet cell hyperplasia and cystic dilatation of submucosal secretory glands were also present in the heavily infested animals. This investigation was designed to record the prevalence together with gross and histopathological changes observed due to C. titillator in camels in eastern provinces of Iran.
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Affiliation(s)
- A Oryan
- Department of Pathobiology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran.
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23
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24
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Huisman TAGM, Brehmer U, Zeilinger G, Stallmach T, Gysin C. Parapharyngeal neuroglial heterotopia extending through the skull base in a neonate with airway obstruction. J Pediatr Surg 2007; 42:1764-7. [PMID: 17923212 DOI: 10.1016/j.jpedsurg.2007.06.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We present a neonate with heterotopic nasopharyngeal brain tissue causing airway obstruction. Preoperative imaging showed extension of the mass along major neurovascular pathways into the cranial vault. Preoperative identification of intracranial extension is essential for planning surgery to prevent postoperative cerebrospinal fluid leaks or possible meningitis.
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Affiliation(s)
- Thierry A G M Huisman
- Department of Diagnostic Imaging, University Hospital Zurich, CH-8032 Zurich, Switzerland.
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25
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De Lorenzi D, Bertoncello D, Bottero E. Squash-preparation cytology from nasopharyngeal masses in the cat: cytological results and histological correlations in 30 cases. J Feline Med Surg 2007; 10:55-60. [PMID: 17869151 DOI: 10.1016/j.jfms.2007.06.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2007] [Indexed: 11/20/2022]
Abstract
Upper airway obstruction in cats can be a life-threatening condition. Early recognition of clinical signs and an appropriate diagnostic approach increases the possibility of appropriate therapeutic choices. The purpose of this study was to assess the efficacy and diagnostic value of squash-preparation cytology in providing an accurate diagnosis of masses growing in the nasopharynx of cats. Cytological specimens prepared by a squash technique from nasopharyngeal masses in 30 cats were collected under direct endoscopic guidance and classified into four groups: benign inflammatory/hyperplastic mass, lymphoma, carcinoma and sarcoma. The cytopathological diagnosis was compared with the final histopathological diagnosis and indices of diagnostic test accuracy were calculated. The results showed good agreement between the cytological and histological diagnosis with a sensitivity of 0.94, a specificity of 0.81, a positive likelihood ratio of 0.9, a negative likelihood ratio of 0.9 and an overall accuracy of 0.9. Squash-preparation cytology is considered an accurate diagnostic tool for distinguishing benign from malignant nasopharyngeal masses in cats. For differentiation of lymphoma and lymphoid reactions histopathological confirmation is recommended.
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Affiliation(s)
- Davide De Lorenzi
- San Marco Private Veterinary Clinic, Via Sorio 114/c, 35141-Padua, Italy.
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Lewis K, Thomas R, Grace R, Moffat C, Manjaly G, Howlett DC. Extramedullary plasmacytomas of the larynx and parapharyngeal space: imaging and pathologic features. Ear Nose Throat J 2007; 86:567-569. [PMID: 17970149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
Extramedullary plasmacytoma is a rare plasma cell neoplasm that can occur in the head and neck. In this article we describe a case of multiple synchronous extramedullary plasmacytomas involving the upper airway, pharynx, and larynx. The clinical, imaging, and pathologic features of this neoplasm are discussed, together with potential treatment options.
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Affiliation(s)
- Khari Lewis
- Department of Oral & Maxillofacial Surgery, East Sussex NHS Trust, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
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Affiliation(s)
- Yu-Chien Chang
- Department of Otolaryngology, Chang Gung Memorial Hospital at Chiayi, Chang Gung University College of Medicine, Taiwan
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Abstract
Thornwaldt's bursa, also known as nasopharyngeal bursa, is a recess in the midline of the nasopharynx that is produced by persistent notochord remnants. If its opening becomes obstructed, possibly due to infection or a complication from adenoidectomy, a Thornwaldt's cyst might develop. Here, we present a 53-year-old man who complained of nasal obstruction that had progressed for 1 year. Nasopharyngoscopy showed a huge nasopharyngeal mass. Thornwaldt's cyst was suspected. Magnetic resonance imaging showed a lesion measuring 3.6 x 3.4 cm, intermediate on T1-weighted and high signal intensity on T2-weighted imaging, neither bony destruction nor connection to the brain. The patient underwent endoscopic surgery for this huge mass. Afterwards, his symptoms improved significantly. We present the treatment and differential diagnosis of a nasopharyngeal cyst.
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Affiliation(s)
- Jia-Hau Lin
- Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Kwon BJ, Han MH, Oh SH, Song JJ, Chang KH. MRI findings and spreading patterns of necrotizing external otitis: Is a poor outcome predictable? Clin Radiol 2006; 61:495-504. [PMID: 16713420 DOI: 10.1016/j.crad.2006.01.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2005] [Revised: 12/17/2005] [Accepted: 01/18/2006] [Indexed: 11/26/2022]
Abstract
AIM To evaluate spreading patterns of necrotizing external otitis (NEO) by magnetic resonance imaging (MRI) and to identify spreading patterns related to a poor outcome. MATERIALS AND METHODS Fourteen patients with NEO were divided into good and poor outcome groups according to their final clinical outcomes. Initial MRI images were retrospectively reviewed for regional abnormalities, and follow-up MRI images were reviewed for ICA flow void abnormality and for the following five spreading patterns: medial, crossed, anterior, intracranial, and combined. The frequencies of the abnormal flow void or spreading patterns were compared between the good and poor response groups. RESULTS Seven (50%) and seven (50%) patients were respectively allocated to the good and poor outcome groups. Retrocondylar fat infiltration was the most commonest finding on initial MRI images (93%). The frequencies of the abnormal flow void and spreading patterns in the good and poor groups, respectively, were: abnormal flow void, 0 and four (57%); anterior, two (29%) and three (43%); medial, six (86%) and seven (100%); crossed, six (86%) and seven (100%); intracranial middle cranial fossa, one (14%) and four (57%); intracranial posterior cranial fossa, four (57%) and six (86%); intracranial foramen magnum, one (14%) and six (86%). CONCLUSIONS NEO almost always involves the retrocondylar fat and spreads via various pathways to extracranial or intracranial spaces. The presence of an abnormal flow void and intracranial dural enhancement, particularly in the middle cranial fossa and foramen magnum, may indicate a poor prognosis.
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Affiliation(s)
- B J Kwon
- Department of Radiology, Seoul National University College of Medicine, and Clinical Research Institute, Seoul National University Hospital, South Korea
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30
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Giannas JE, Bayat A, Davenport PJ. Heterotopic nasopharyngeal brain tissue associated with cleft palate. ACTA ACUST UNITED AC 2005; 58:862-4. [PMID: 16086995 DOI: 10.1016/j.bjps.2004.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2003] [Revised: 11/22/2004] [Accepted: 12/15/2004] [Indexed: 10/25/2022]
Abstract
Heterotopic brain tissue in a cleft palate is a very rare developmental anomaly. We present the eighth case reported worldwide with a review of the literature and suggestions on the management of this unusual condition.
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Affiliation(s)
- J E Giannas
- Department of Plastic and Reconstructive Surgery, Booth Hall Children's Hospital, Manchester, UK.
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Abstract
OBJECTIVES/HYPOTHESIS To present the clinical manifestation of nasopharyngeal tuberculosis. STUDY DESIGN Clinical analysis of 23 patients with pathologically confirmed nasopharyngeal tuberculosis was carried out retrospectively. SETTING Srinagarind Hospital, Khon Kaen University. Thailand. RESULTS The most common presenting symptom was cervical lymphadenopathy (91.3%). The common locations of nodes were the superior and middle cervical. The abnormalities of the nasopharynx were found in 16 patients. The pathological findings were caseous granuloma with positive acid-fast bacilli (AFB) in 15 cases, caseous granuloma with negative AFB in 3 cases, and chronic granulomatous inflammation with negative AFB in 5 cases. Pulmonary tuberculosis was found in 8 of 18 patients. Sixteen patients who received complete treatment responded well. CONCLUSION Nasopharyngeal tuberculosis commonly presents with cervical lymphadenopathy. The differential diagnosis of tuberculosis from nasopharyngeal carcinoma is difficult. In the patients who have cervical lymphadenopathy and no other identified causes, biopsy of nasopharynx would give an additive information for diagnosis.
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Affiliation(s)
- Somchai Srirompotong
- Department of Otolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
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Yuca K, Etlik O, Kiroğlu AF, Celebi S, Yakut F. Endoscopic view and MRI of a Thornwaldt's cyst of the nasopharynx. B-ENT 2005; 1:155-7. [PMID: 16255501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
A Thornwaldt's cyst is an uncommon nasopharyngeal lesion that develops from the remnant of the primitive notochord. A 65-year-old man with a Thornwaldt's cyst is presented in this case report. The patient was diagnosed by rigid nasal endoscopy and magnetic resonance imaging (MRI). These cases are infrequently presented in the English journals. Our study suggested that endoscopic and MRI examinations of the nasopharynx were a simple, rapid, and useful procedure for the diagnosis of the Thornwaldt's cysts.
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Affiliation(s)
- K Yuca
- Department of Otorhinolaryngology, Faculty of Medicine, Yüzüncü Yýl University, Van, Turkey.
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Plaza Mayor G, Pinedo Moraleda F, Ferrando Alvarez-Cortina J, Espinosa Gimeno A, de los Santos Granados G. [Otalgia as presentation of primary nasopharynx tuberculosis]. An Otorrinolaringol Ibero Am 2005; 32:585-91. [PMID: 16475546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
We report a case of a 63-year-old woman who presented with left otalgia during more than six months. On examination, otoscopy was normal, whereas flexible nasopharyngoscopy revealed an asymmetry in the nasopharynx. CT scans confirmed the presence of a left nasopharyngeal mass. A transnasal endoscopic removal of the nasopharyngeal lesion was performed. Necrotizing granulomatosis was found. Tuberculosis of the nasopharynx was considered the final diagnosis, but oral treatment was not started. After 36 months of follow-up, nasal endoscopy and CT images show no sign of recurrence. Discussion is focused on the inclusion of nasopharyngeal diseases in otalgia differential diagnosis, histopathological diagnosis of granulomas and the need of any further treatment for these limited cases of extrapulmonary tuberculosis.
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Affiliation(s)
- G Plaza Mayor
- Fundacion Hospital Alcorcón, Unidad de Otorrinolaringología, Madrid.
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Abstract
Hairy polyps are rare congenital benign tumors that usually present a pedunculated mass in the oronasopharynx. A hairy polyp originating from the left eustachian tube orifice was found in a 7-month-old girl presenting sleep apnea and blood-tinged vomiting. This was successfully removed by transoral surgery under endoscopic visualization. The endoscope-guided surgery may help avoid undesirable complications as well as completely excise the lesions attached close to the eustachian tube openings.
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Affiliation(s)
- Jong-Lyel Roh
- Department of Otolaryngology-Head and Neck Surgery, Cancer Research Institute, College of Medicine, Chungnam National University, 640 Daesa-Dong, Chung-Gu, Daejeon 301-040, South Korea.
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Marín Gabriel MA, Medina López C, Delgado Muñoz MD, Rodríguez Gil Y. Gastric heterotopia in the nasopharynx causing airway obstruction in the newborn. Int J Pediatr Otorhinolaryngol 2004; 68:961-4. [PMID: 15183589 DOI: 10.1016/j.ijporl.2004.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2003] [Revised: 02/02/2004] [Accepted: 02/03/2004] [Indexed: 11/17/2022]
Abstract
We describe a newborn boy with a gastric heterotopia located in the nasopharynx, which caused airway obstruction soon after delivery. Gastric heterotopia is an uncommon lesion generally found throughout the alimentary tract, but nasopharynx is an exceptional location. To our knowledge, this is the second reported case of gastric heterotopia located in the nasopharynx, and the first one presenting in a newborn with symptoms at birth and with an associated central nervous system mass.
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Affiliation(s)
- Miguel A Marín Gabriel
- Department of Neonatology, 12 October Hospital, Avda. De Córdoba s/n, C.P. 28041 Madrid, Spain.
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Takano KI, Sato J, Shirasaki H, Yamazaki N, Hoki K, Himi T. Melanin pigmented oncocytic metaplasia of the nasopharynx. Auris Nasus Larynx 2004; 31:161-3. [PMID: 15121226 DOI: 10.1016/j.anl.2004.01.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2003] [Accepted: 01/16/2004] [Indexed: 11/16/2022]
Abstract
A case of melanin pigmented oncocytic metaplasia is reported. A 62-year-old man presented with a history of discomfort of the ear of a 2 weeks' duration. Nasoscopic examination revealed a black nodule of about 5mm at the left Eustachian opening, and several black spots were discovered around the bilateral torus tubarius. The nodule was biopsied to determine the histology. Microscopically, there were oncocytic cells with abundant pigmented granules showing glandular pattern. Such a pigmented variant of benign oncocytic lesion is very rare.
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Affiliation(s)
- Ken-ichi Takano
- Department of Otolaryngology, Sapporo Medical University School of Medicine, Chuou-ku, Sapporo 060-8556, Japan.
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Sakaki M, Shek TWH, Hirokawa M, Kashima K, Daa T, Gamachi A, Sano T. Melanotic oncocytic metaplasia of the nasopharynx: a report of seven cases and review of the literature. Virchows Arch 2004; 444:345-9. [PMID: 14762715 DOI: 10.1007/s00428-003-0970-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2003] [Accepted: 12/17/2003] [Indexed: 10/26/2022]
Abstract
We describe seven cases of melanotic oncocytic metaplasia of the nasopharynx and review five other cases in the literature. It is usually a small, brown to black lesion that occurs around the Eustachian tube opening, where abundant seromucinous glands and lymphoid tissue are present. Multiple or bilateral lesions are sometimes seen. All 12 reported cases are of Asian origin. Melanotic oncocytic metaplasia occurs predominantly in men (male:female=11:1), with a mean age of 68 years. Simple excisional biopsy appears to be curative. Microscopically, melanotic oncocytic metaplasia is a combination of oncocytic metaplasia of the epithelium of the gland and melanin pigmentation in its cytoplasm. Fontana-Masson staining and immunohistochemical staining of S-100 protein revealed numerous melanocytes with conspicuous dendrites in the glands and stroma, which probably transfer melanin to adjacent glands. The exact pathogenesis of melanotic oncocytic metaplasia is unknown, but we postulate that the lesion could be related to the oncocytic metaplasia of the seromucinous glands around the Eustachian tube, which is followed by the local production and/or acquisition of the melanin pigment, under the influence of certain neuropeptides in the vicinity. The recognition of melanotic oncocytic metaplasia is of clinical importance, as it may be misdiagnosed as a malignancy to the unwary.
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Affiliation(s)
- Mika Sakaki
- Department of Pathology, University of Tokushima School of Medicine, 3-18-15 Kuramoto-cho, 770-8503 Tokushima, Japan.
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Abstract
OBJECTIVES/HYPOTHESIS To delineate the clinical and pathologic characteristics of upper aerodigestive tract amyloidosis with particular attention to laryngeal amyloidosis. STUDY DESIGN Retrospective chart review of patients with amyloidosis of Thomas Jefferson University and its affiliated hospitals. MATERIAL AND METHODS The charts of 16 patients with upper aerodigestive tract amyloidosis identified from the databases of the Thomas Jefferson University pathology department were reviewed and included in the study. RESULTS Sixteen patients (9 male and 7 female, with an average age of 49.8 years) with upper aerodigestive tract amyloidosis were identified. The most common site of amyloid involvement was the larynx. Consequently, patients most commonly presented with hoarseness (14 of 16). All patients underwent surgical removal of the amyloid deposits. Fourteen patients had primary localized amyloidosis. Two experienced systemic involvement. Seven of the 16 patients developed recurrences requiring further treatment. CONCLUSIONS Amyloidosis of the upper aerodigestive tract generally behaves as a benign, localized condition treatable by surgical resection. Regular follow-up with laryngoscopy is indicated for early diagnosis of recurrence, and multiple surgical procedures may be required to control symptoms.
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Affiliation(s)
- Edmund Pribitkin
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, 1721 Pine Street, Philadelphia, PA, USA
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Ayanoglu E, Uneri C, Turoglu T, Dogan V. Reflux of nasopharyngeal content into middle ear through the eustachian tube. Eur Arch Otorhinolaryngol 2003; 261:439-44. [PMID: 14624304 DOI: 10.1007/s00405-003-0709-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2003] [Accepted: 10/07/2003] [Indexed: 10/26/2022]
Abstract
Whether nasopharyngeal content passes into the middle ear in patients without any head and neck pathology during the recovery phase of anesthesia is shown with an objective and prospective method. Thirty-eight patients, 21 female and 17 male, aged between 17 and 76, were included in the study. During the recovery phase of general anesthesia, 10 ml of 5 mCi Tc-99m-MAA was administered intranasally to the patients with a 10-F catheter. A manometer-adapted cuffed intubation tube was placed in the nasal passage so that the cuff was located at the choana. The pressure changes reflecting to the nasopharynx were recorded. The patients were extubated 10 min after the radionuclide was applied. The scintigraphic evaluation was done at the end of the 1st hour of the application of radionuclide. Transmission and emission views were taken with a gamma camera. Passage of nasopharyngeal content into the middle ear via the eustachian tube was not a statistically significant observation. The mean value of maximum pressure reflecting from the nasopharynx did not differ significantly between patients. Our study does not support the hypothesis that nasopharyngeal content passes directly through the eustachian tube into the middle ear and causes deleterious effects.
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Affiliation(s)
- Elif Ayanoglu
- Department of Otorhinolaryngology and Head and Neck Surgery, Marmara University Hospital, Istanbul, Turkey.
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Lau DP, Huang Z, Lui H, Man CS, Berean K, Morrison MD, Zeng H. Raman spectroscopy for optical diagnosis in normal and cancerous tissue of the nasopharynx-preliminary findings. Lasers Surg Med 2003; 32:210-4. [PMID: 12605428 DOI: 10.1002/lsm.10084] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND AND OBJECTIVES Raman spectroscopy (RS), which can detect molecular changes associated with cancer, was explored as a means of distinguishing normal and cancerous nasopharyngeal tissue. STUDY DESIGN/PATIENTS AND METHODS Tissue from six patients with normal and cancerous biopsies was studied using a rapid acquisition Raman spectrometer. RESULTS Spectra were obtainable within 5 seconds. Consistent differences were noted between normal and cancer tissue in three bands 1,290-1,320 cm(-1) (P = 0.005), 1,420-1,470 cm(-1) (P = 0.006), and 1,530-1,580 cm(-1) (P = 0.002). CONCLUSIONS Spectral differences appear to exist between normal and cancerous nasopharyngeal tissue. The ability to obtain spectra rapidly supports the potential for future in vivo application.
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Affiliation(s)
- David P Lau
- Division of Otolaryngology, University of British Columbia/Vancouver General Hospital, Canada V5Z 1M9
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Abstract
OBJECTIVES Tuberculosis of the nasopharynx is uncommon. A large series of 17 cases is reported, and the clinical and pathological features are discussed. STUDY DESIGN A retrospective review. METHODS Seventeen archived cases of biopsy-proven nasopharyngeal tuberculosis were reviewed for patient age and sex, presenting complaint and duration, systemic symptoms, cervical lymphadenopathy, and chest x-ray findings. These findings were compared with a compilation of 40 cases reported in the English literature. RESULTS There was a female predominance (13 women and 4 men), with age range of 20 to 74 years (mean age, 38 y). The most common presentation was enlargement of the cervical lymph nodes (53%), followed by hearing loss (12%), tinnitus, otalgia, nasal obstruction, and postnasal drip (6% each). The duration of the presenting symptoms ranged from 1 week to 1 year (mean duration, 16 wk). Ten patients (59%) had cervical lymphadenopathy, two (12%) had systemic symptoms (fever, weight loss, night sweats), and one patient (6%) had miliary pulmonary tuberculosis. Direct endoscopic examination showed nasopharyngeal mucosal irregularity or mass in the majority of patients (12 patients [70%]). These features were similar to those reported in the literature. CONCLUSIONS Nasopharyngeal tuberculosis is uncommon, usually occurring without pulmonary or systemic involvement. Cervical lymphadenopathy occurs in more than half of the patients and is the most common presenting complaint; this, together with the nasopharyngeal findings of mass or mucosal irregularity, makes differentiation from carcinoma on clinical examination difficult, necessitating histological evaluation.
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Affiliation(s)
- Gary M K Tse
- Department of Anatomical and Cellular Pathology, Division of Otorhinolaryngology, Prince of Wales Hospital, Chinese University of Hong Kong, Republic of China.
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Affiliation(s)
- Sui-Ling Liao
- Division of Neonatology, Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan, ROC
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Yilmaz MD, Dereköy FS, Aktepe F, Altuntaş A. [A report of Thornwaldt's cyst in four patients: the effectiveness of endoscopic approach in three symptomatic cases]. Kulak Burun Bogaz Ihtis Derg 2003; 10:74-7. [PMID: 12717060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
We encountered Thornwaldt cysts in four patients (3 males, 1 female; age range 30 to 46 years). Three symptomatic patients underwent endoscopic surgery. No intervention was made in one asymptomatic patient. Cyst-related complications included bilateral middle ear effusion in one patient. Postoperatively, no symptoms or recurrences were observed in a mean follow-up period of 11 months. In the asymptomatic patient, the cyst size remained unchanged during eight-month follow-up.
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Affiliation(s)
- Mustafa Deniz Yilmaz
- Department of Otolaryngology, Medicine Faculty of Afyon Kocatepe University, Turkey.
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Ngoc-Limb N, Minh-Thong T, Sao-Trung N, Truong-Minh-Ky E, Vuong PN. [Nasopharyngeal rhinosporidosis mimicking angiofibroma in a Cambodian adolescent]. Presse Med 2003; 32:27. [PMID: 12617066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
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Merrot O, Fayoux P, Vachin F, Desaulty A, Chevalier D. [Zenker's diverticulum in the elderly patient: evolution of endoscopic treatment using a CO2 laser]. Rev Laryngol Otol Rhinol (Bord) 2003; 124:321-4. [PMID: 15144029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVES The authors report their experience in a retrospective study of 28 patients with symptomatic hypopharyngeal diverticulum. MATERIAL AND METHOD The mean age was 70 years. Eight patients presented with severe dysphagia and nine with weight's loss. The delay before diagnosis was 17 months. All patients included were studied by an oesophageal barium swallow prior to any treatment. According to Van Overbeeck's classification, diverticula were medium sized in 11 patients, small in 8 and large in 7. All patients had endoscopic assessment of the diverticular pouch; 26 patients were treated by microendoscopic laser myotomy and 2 by resection. RESULTS The average time for oral feeding was 4 days. None of the 28 cases had a postoperative complication. 25 patients had partial or complete relief of symptoms after their initial treatment. In 3 cases recurrence of symptoms occurred, of whom 2 underwent endoscopic revision and 1 underwent an open procedure. CONCLUSION Endoscopic laser surgery for Zenker's diverticulum can be recommended as the treatment of choice for elderly patients. It is a useful procedure because it is swift, effective with a low rate of morbidity, even in cases with impaired of health or associated diseases.
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Affiliation(s)
- O Merrot
- Hôpital de La Croix-Rousse Service Pr Pignat, 103 Grande Rue de La Croix-Rousse 69317 Lyon cedex 04, France.
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Zhang S, Liu H, Wang Y, Li Q, He C. [An etiological and clinicopathological study of early syphilis in oropharynx]. Zhonghua Er Bi Yan Hou Ke Za Zhi 2002; 37:450-3. [PMID: 12966808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
OBJECTIVE To investigate the characteristics of the early stage treponema pallidum infected tissue in ear, nose, oropharynx and larynx and to raise relevance ratio of syphilis in nose and oropharynx and enhance doctor's self-protection awareness. METHODS The histopathologic characteristics were studied by using HE staining, Warthin-Starry (W-S) staining was adopted to examine the treponema pallidum(TP) in lesion issue and its exudates smear for 12 cases biopsy tissues of suspicious syphilis. The diagnosis was confirmed by venereal disease research laboratory (VDRL), rapid plasma reagin circle test(RPR), treponema pallidum hemagglutination test(TPHA) and fluorescent treponemal antibody-absorption test (FTA-ABS). Treat with curing syphilis methods which published by nation. RESULTS In the 12 cases mucous membrane specimen, the squamous epithelium proliferated, neutrophilic granulocyte infiltrated, within inherent membrane generous plasmacyte and lymphocyte infiltrated. W-S staining: plenty of treponema pallidum were found inside mucous membrane epithelium and exudate smear. Serology examination: 11 cases VDRL(++++), 7 cases RPR (+), 11 cases TPHA(+), 1 case FTA-ABS(+). After systemic treatment, 11 cases are clinically recovered. All patients serology become negative. CONCLUSION W-S staining method can directly demonstrate histopathologic characteristics in early syphilis, in intrinsic membrane numerous plasmacyte infiltration. Combining with specific syphilis serology examination could increase diagnosis rate of syphilis in nose and oropharynx.
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Affiliation(s)
- Shengzhong Zhang
- Department of Pathology, Beijing Tong Ren Hospital, Capital University of Medical Science, Beijing 100730, China.
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Abstract
This report describes a case of cytomegalovirus (CMV) infection of the nasopharynx. A 47 year old man presented with a nasopharyngeal mass of one month's duration. The patient had a history of pneumonia one month previously. Sinus computed tomography incidentally picked up a nasopharyngeal mass. The initial biopsy showed lymphoid hyperplasia. Repeated nasopharyngoscopy showed a prominent central nasopharyngeal mass without ulceration. Histology of the nasopharyngeal biopsy revealed several enlarged epithelial cells with characteristic CMV cytopathic changes. An immunohistochemical study, using a monoclonal IgG antibody against a CMV antigen, confirmed CMV infection. The patient's nasopharyngeal mass decreased in size gradually on follow up. To the best of our knowledge, this is the first reported case of CMV infection of the nasopharynx in the English literature. This disease entity should be considered in those patients presenting with nasopharyngeal mass, biopsy negative for malignancy, and no underlying immunosuppression or immunodeficiency.
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Affiliation(s)
- B W Chan
- Department of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, PR China.
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Kharoubi S. [A rare case of sarcoidosis localization: the cavum]. Rev Laryngol Otol Rhinol (Bord) 2002; 123:115-8. [PMID: 12360718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
We present a single case of isolated sarcoidosis pseudo-tumour of the cavum. The patient presented with progressive nasal obstruction. A well confirmed mass at the roof of the cavum was seen with the endoscope. Histological diagnosis was made following endoscopic biopsy of the mass. The general examination was negative. There were no further signs of disease progression after 8 months of treatment.
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Affiliation(s)
- S Kharoubi
- CHU Ibn Rochd, Service d'ORL, Annaba, Algérie
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