Cigarette smoking intensifies tendinopathy of the LHBT. A microscopic study after arthroscopic treatment.

Smoking has a damaging effect on the musculoskeletal system, which was presented by authors in the rotator cuff and Achilles tendons studies; however, there are a lack of data about the effect of smoking on disorders of the long head of the biceps tendon (LHBT), particularly at the microscopic level. The purpose of this study was to investigate the effect of the tobacco smoking on the histopathologic alterations of the LHBT. Thirty-six patients with preoperatively diagnosed tendinopathy of the LHBT were referred to the Orthopaedics Department. All patients underwent arthroscopic treatment with further macroscopic and microscopic evaluation of biceps tendon samples. The active and former smokers were characterised by more advanced degenerative process of the tendinous tissue; moreover, it was intensified in the group of former smokers. Subjects who smoke more than 20 cigarettes per day also had more advanced microscopic alterations. The most severe microscopic alterations occurred in the former smokers who used tobacco for more than 20 years. However, the non-smokers group revealed moderate degeneration in all LHBT samples. Tobacco smoking is an important risk factor of the LHBT disease, which essentially intensifies the degeneration of the tendinous tissue.

Is the inflammation process absolutely absent in tendinopathy of the long head of the biceps tendon? Histopathologic study of the long head of the biceps tendon after arthroscopic treatment.

Tendinopathy of the long head of the biceps tendon is a difficult medical issue. Its pathogenesis and etiology is multifactorial and unclear. Tendinopathy is thought to be primarily degenerative in nature, as tendons are characterized by impaired regeneration and healing. Thirty-five patients with preoperatively diagnosed tendinopathy of long head of the biceps tendon were referred to the Orthopedics Department. All patients underwent an arthroscopic-assisted biceps tenodesis or tenotomy. The intra-articular portion of the long head of the biceps tendon was obtained from each of the patients who underwent arthroscopy. A macroscopic and microscopic evaluation of biceps tendon samples revealed degeneration among all specimens. This study demonstrates the prevalence of the degeneration process and the presence of marginal inflammation process in tendinopathy of the long head of biceps tendon. The role, that inflammation process plays in tendinopathy is important in the early phase and gradually becomes secondary to the developing degeneration. The inflammatory cells, occasionally seen in pathological tendons, could be an evidence of re-injury and recent healing response.

Problems with diagnostic work-up of musculoskeletal pain due to glomus tumour. Four case reports.

INTRODUCTION: Glomus tumours are rare benign neoplasms of myoepithelial origin. Due to characteristic and painful symptoms, glomus tumours are a major clinical problem. MATERIAL: Four histologically confirmed cases of glomangioma treated at the Orthopaedics & Traumatology Department between 1999 and 2007. RESULTS: The most significant symptom was extreme pain causing a decrease in the quality of life. Regardless of the location of the tumour, the correct diagnosis was delayed by 1.5 to 3 years. CONCLUSIONS: Due to its rare occurrence, glomus tumours are often missed out in the differential diagnosis of musculoskeletal pain. The agonising pain makes glomus tumours a significant clinical problem that should be remembered about, especially as surgery brings about spectacular improvement.

[A case of giant-size mucoepidermoid carcinoma of parotid gland]. / Przypadek olbrzymiego guza--raka sluzowo-naskórkowego slinianki przyusznej.

INTRODUCTION: A mucoepidermoid carcinoma is a rare disease of the salivary glands. It usually occurs as a small tumor (a few centimeters diameter). The most important diagnostic procedure for the treatment is a histological examination. MATERIAL AND METHODS: We present the case of 71 years old woman with giant in size tumor of the left parotid gland. The tumor had developed in the three years' time and no paresis of the facial nerve had occurred during that time. Preoperative fine needle aspiration biopsy of the parotid gland masses showed pleomorphic adenoma cells. RESULTS: The surgery treatment was introduced. The function of the facial nerve was preserved. The histological examination result was mucoepidermoid carcinoma. We observed local recurrence of the tumor five months after the operation. But there was still no facial nerve paralysis. The patient was submitted to the radiotherapy treatment. CONCLUSION: The big size of the tumor may be an obstacle in full resection during an operation. The false negative results during a fine needle aspiration and preserved normal function of the facial nerve can cause correct treatment as an extremely difficult goal.

[Cervical sympathetic chain neurilemmoma--a case report]. / Przypadek neurilemmoma szyi z pnia wspólczulnego.

INTRODUCTION: Neurilemmoma is benign, slowly growing tumour that arise from nerves. Cervical sympathetic chain neurilemmoma is rare. The majority of neurilemmomas are asymptomatic at the time of presentation. The incidence of Horner's syndrome before excision has been reported only once. Surgical resection almost leaves the patient with a Horner's syndrome. MATERIAL AND METHODS: A 28 years old woman was admitted to Otolaryngology Department with left side neck mass. The tumor was first noticed 6 month later, and it was slowly growing. It was completely asymptomatic. She underwent excision of the tumor through an incision parallel with the anterior border of the strenomastoid muscle. RESULTS: Histology showed the tumour to be a neurilemmoma arising within the cervical sympathetic chain. During postoperative period in 2 day we observed a left side Horner's syndrome, completely asymptomatic. CONCLUSIONS: Neurilemmomas very rarely arise from the cervical sympathetic chain. They usually present as asymptomatic neck mass. The only complication encountered after surgery is Horner's syndrome, which required no treatment.

[Plasmacytoma of the larynx]. / Szpiczak krtani.

Multiple myeloma is a neoplastic proliferation of the plasma cells of clonal character producing similar immunoglobulin or part of the immunoglobulin. Multiple myeloma occasionally occurs as solitary, extramedullary plasmacytoma. The location of plasmacytoma in the larynx is extremely rare. We are describing the case of the larynx plasmacytoma diagnosed for a 79 years old female patient. After histopathologic diagnosis of the laryngeal polyp the patient was examined hematologically in great detail aiming at the investigation of myeloma multiplex. No features of multiple myeloma have been found. Now the patient is under strict laryngological and hematological care.

Lymphangioma and lymphangiomyomatosis--the same lesion?

The authors present a very rare case observed in a 32 year old female with a huge tumor on the left side of the neck in which extensive changes characteristic for cystic lymphangioma in the lower part and for lymphangiomyomatosis in the upper part of the tumor were observed intraoperatively. On the basis of the discussed case the suggestion is put forward that these two rarely occurring diseases may have similar etiological grounds.

[Benign osteoblastoma of the frontal sinus]. / Osteoblastoma benignum zatoki czolowej.

The extremely rare case of benign osteoblastoma of frontal sinus was presented. Uncharacteristic clinical symptoms, radiological investigations and differentiation diagnostic were analysed. The operation treatment, which was chosen in that case, was described. It was agreeing with treatment presented by the other Polish and foreign authors.