Eosinophilic angiocentric fibrosis as a cause of nasal obstruction.

We present the tenth case of Eosinophilic Angiocentric Fibrosis (EAF) in the english literature, which presented as nasal obstruction in a patient of Indian descent. The histopathological and clinical features of this underreported condition is discussed as well as other lesions that may show similar features to EAF.

Oncocytomas of the upper jaw.

BACKGROUND: Oncocytomas are rare tumors; they occur most often in the parotid gland and here behave in a benign fashion. Few of these tumours have been described arising from tissues of the upper jaw. The reviews of the literature in these cases often appear incomplete. It has been suggested that outside the major salivary glands oncocytomas should be considered to be low-grade adenocarcinomas. METHODS: We present a case of a 78-year-old woman with a frankly malignant oncocytoma of the lateral nasal wall, treated with radical local excision. A search of the world literature was undertaken and a review conducted. RESULTS: We found a total of 19 cases affecting the upper jaw, in a wide age distribution, 10 male and 9 female. Thirteen cases were malignant, 3 with metastases. CONCLUSIONS: When affecting the upper jaw, these tumors must be considered malignant. Radical surgical excision is the treatment most often employed.

Metastatic adenocarcinoma of the ethmoids in a patient with previous gastric adenocarcinoma: a case report.

Metastatic carcinoma of the ethmoids is very rare. Of the few cases reported in the literature, the majority are renal in origin. Although metastases from the gastrointestinal tract have been reported, there are no known cases of metastases from the stomach. We present a rare case of metastatic adenocarcinoma of the ethmoids in a patient previously treated for adenocarcinoma of the stomach and describe the possible mechanisms of spread. The patient had a craniofacial resection of the tumour but unfortunately died four weeks post-operatively from acute liver failure probably caused by a liver metastasis.

Polycystic disease of salivary glands.

Polycystic disease of salivary glands is a rare condition which hitherto has been reported only in the parotid glands. We report a case in which an accessory salivary gland had evidence of polycystic disease.

Post-irradiation carcinosarcoma of the parotid gland.

Carcinosarcoma of the salivary glands are rare tumours, often associated with a history of pleomorphic adenoma. A case of carcinosarcoma of the parotid arising following irradiation to the resection site of a pleomorphic adenoma is presented. The clinical and histological features are discussed and the literature reviewed.

Vocal process granulomata.

The case records and histology of 34 patients with vocal process granulomata were reviewed. The five patients presenting most recently with idiopathic vocal process granulomata were investigated by axial computerized tomography (CT). Increased density of the arytenoid cartilage on the side of the lesion was found in all five cases. It is suggested that this indicates cartilage ossification, secondary to perichondritis. This perichondritis, playing either a primary or a secondary role in granuloma development, may explain the annoying tendency of vocal fold granulomata to recur after excision.

Basaloid carcinomas of salivary glands.

Three cases of carcinoma of major salivary glands with basaloid morphology are presented. One case was a clear example of a basal cell adenocarcinoma, an uncommon and infrequently recognized. low-grade tumour of major salivary glands. The remaining two cases showed a higher cytological grade of malignancy but shared some features of basal cell adenocarcinoma. Common features included the architectural pattern and myoepithelial cell differentiation, as demonstrated by smooth muscle-specific actin positivity, in cells associated with the deposition of extracellular basal lamina-like material. The relationship between these cases and adenoid cystic carcinoma is discussed.

Tracheal paraganglioma.

The trachea is an unusual site for paragangliomas, only four cases having been documented previously. A fifth case is presented here, together with immunohistochemical evidence that the tumour is biologically benign.

Leiomyoma of the paranasal sinuses.

The paranasal sinuses are a rare site for tumours of myogenic origin. There has been only one previously reported case in the English literature. We present a case of a leiomyoma filling the anterior ethmoid sinus and middle meatus which was excised via a Patterson's external ethmoidectomy.

Laryngeal imaging by computerized tomography and magnetic resonance following radiation therapy: a need for caution.

For patients with laryngeal tumours, the use of computerized tomography (CT) or magnetic resonance imaging (MR) may facilitate accurate staging by the demonstration of cartilage invasion or tumour extension to areas such as the pre-epiglottic space. The role of imaging in the follow-up of patients after radiotherapy, however, has not been examined. A prospective study of 18 patients undergoing laryngectomy was performed. The results of pre-operative CT and MR imaging were correlated with the pathological findings from whole organ axial sections of the laryngeal specimens. In five patients (28 per cent) both CT and MR images were significantly impaired by movement artefact. In the eight patients without previous radiotherapy, seven had adequate quality imaging and both CT and MR accurately demonstrated the site, size and extent of laryngeal tumour. In eight of the ten patients following radiation therapy the presence of tumour was correctly identified, however there was a poor correlation between the imaging and pathological findings. Two patients had radionecrosis alone. Neither CT nor MR imaging could differentiate between radionecrosis and recurrent tumour.

Nucleolar organizer regions in benign and malignant glandular lesions of the cervix.

The argyrophil technique for nucleolar organizer regions was applied to cases of normal cervix (n = 6), microglandular hyperplasia (n = 6), adenocarcinoma in situ (n = 15), and invasive adenocarcinoma of the cervix (n = 19). A rigorous staining technique was employed which facilitated the enumeration of individual AgNORs even when they were aggregated as tight clusters within the nucleolus (AgNUs). Two methods of counting AgNORs were used: a simple enumeration of dispersed AgNORs and AgNUs, and the more time-consuming counting of all individual AgNORs, including those within AgNUs. With both techniques, there was no significant difference in counts between in situ and invasive adenocarcinoma, but cases of microglandular hyperplasia showed significantly fewer AgNORs than either of these. This suggests that AgNORs may be useful in differentiating difficult cases of microglandular hyperplasia from adenocarcinoma and that the simplified counting technique is adequate for this purpose. AgNOR counts are of no use in discriminating between invasive and in situ adenocarcinoma.

Meckel syndrome: prenatal ultrasonographic diagnosis in two cases showing marked differences in phenotypic expression.

Two consecutive siblings with the Meckel-Gruber syndrome are presented. They demonstrate variation in phenotypic expression which may render diagnosis difficult when the pattern of malformation is significantly different from that traditionally accepted. The diagnosis was only made with confidence because a sibling with typical features had been seen first. The usefulness of ultrasound in prenatal diagnosis, even when the abnormalities are atypical, is well illustrated.

Subcutaneous sarcoidosis mimicking carcinoma of the breast.

A 65 year old woman presented with bilateral breast lumps. Clinical examination suggested a diagnosis of mammary carcinoma, but a histological diagnosis of sarcoidosis was made. Subsequent investigations revealed evidence of pulmonary sarcoidosis.