Localized primary gastric amyloidosis: Three case reports.

BACKGROUND: Localized primary gastric amyloidosis is a rare disorder characterized by the extracellular deposition of insoluble fibrillary protein in the stomach and can mimic various diseases on endoscopic examination, including gastrointestinal stromal tumors, gastric cancer and ulcers. CASE SUMMARIES: Here, we report a series of three cases of localized gastric amyloidosis mimicking gastric mucosa-associated lymphoid tissue (MALT) lymphoma on endoscopic examination that were evaluated over the past ten years in our hospital. The different detection times of this rare disease resulted in three completely different outcomes, indicating the strong importance of early detection, diagnosis and treatment. The difficulties encountered in making an accurate diagnosis and differential diagnosis are highlighted, and this report provides clinical experience for the diagnosis of localized primary gastric amyloidosis. CONCLUSION: Localized gastric amyloidosis is a rare metabolic disease that resembles MALT lymphoma. Early detection, diagnosis and treatment of localized gastric amyloidosis result in an excellent prognosis.

Malignant minor salivary gland carcinomas of the larynx.

AIMS: To explore the clinical characteristics and treatment of malignant minor salivary gland carcinomas of the larynx. METHODS: Clinical patient information regarding presentation, pathology, treatment and outcome was obtained through a review of patient charts. RESULTS: Malignant minor salivary carcinomas in the larynx were confirmed pathologically in 15 patients (11 males, 4 females) between 2003 and 2010 in our hospital; 6 patients had mucoepidermoid carcinoma (MEC; 40%), 6 had adenoid cystic carcinoma (ACC; 40%) and 3 had adenocarcinoma (20%). The most common tumour location was the subglottis (60%), followed by the supraglottis (33%). In total, 13 patients underwent surgery, of which 10 (77%) had positive/insufficient resection margins. The mean follow-up time was 42.3 months, with a range of 8-129 months. The 3- and 5-year overall survival rates were 46.7 and 20%, respectively. CONCLUSION: Malignant minor salivary gland carcinoma of the larynx is a rare disease that showed male predominance in our study. The carcinomas were most often localised in the subglottic region, and the most common histological types were ACC and MEC. Wide-margin surgery with postoperative radiotherapy is advocated. The overall prognosis is poor compared to squamous cell carcinomas of the same location and tumour stage.

[Primary mucosal tuberculosis of head and neck region: a clinicopathologic analysis of 47 cases].

OBJECTIVE: To study the clinicopathologic features, histologic diagnosis and differential diagnosis of primary mucosal tuberculosis (TB) in the head and neck region. METHODS: Forty-seven cases of primary mucosal TB of the head and neck region were studied by hematoxylin-eosin and Ziehl-Neelsen stains. The clinical and pathologic features were analyzed with review of the literature. RESULTS: The patients included 26 male and 21 female, with mean age 47.1 years (range 14-84 years). There were three sinonasal TB, 19 nasopharyngeal TB, two oropharyngeal TB, 18 laryngeal TB, four middle ear TB, one salivary gland TB and one laryngeal TB complicating laryngeal cancer. The initial symptoms were nasal obstruction, mucopurulent rhinorrhea, epistaxis, snoring, hoarseness, dysphagia, odynophagia, serous otitis, hearing loss, tinnitus, and otalgia. Physical examination result was variable, from an apparently normal mucosa, to an evident mass, or a mucosa with an adenotic or swollen appearance, ulcers, leukoplakic areas, and various combinations thereof. CT and MRI findings included diffuse thickening, a soft-tissue mass, calcification within the mass and bone destruction resembling malignancy. Histologic examination showed granulomas with a central necrotic focus surrounded by epithelioid histiocytes and multinucleated Langhan's giant cells. Acid-fast bacilli were difficult to demonstrate but found in 13/45 cases. Follow-up data were available in 42 patients. CONCLUSIONS: Primary TB arising in the head and neck mucosa is rare. It may mimic or co-exist with other conditions. The characteristic histopathology is a granuloma with central caseous necrosis and Langhans'giant cells. Identification of acid-fast bacilli and bacteriologic culture confirm the diagnosis of mycobacterial disease.