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1.
Medicine (Baltimore) ; 100(35): e27136, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477164

RESUMO

RATIONALE: Small cell neuroendocrine carcinoma of the nasal cavity and paranasal sinuses is a rare but aggressive neoplasm with a poor prognosis and a strong propensity for regional recurrence and distant metastasis. Diagnosis is challenging and relies on immunohistochemical study. Treatment includes surgical resection, radiation therapy, chemotherapy, or a combination of these modalities. However, the optimal therapeutic strategy is still controversial. Due to its rarity, the complexity of the histological diagnosis, and the variety of the treatment regimens, we presented a case of primary small cell neuroendocrine carcinoma in the nasal cavity with description of the clinical manifestation, pathology features, and our treatment regimen. PATIENT CONCERNS: An 82-year-old female patient with hypertension presented with right epistaxis on and off with nasal obstruction for several days. DIAGNOSIS: An exophytic mass over the posterior end of the right inferior turbinate was found on nasopharyngoscope. Biopsy was done and the pathology confirmed small cell carcinoma, strongly positive for cytokeratin (AE1/AE3) and insulinoma-associated protein 1 (INSM-1), scatteredly positive for chromogranin A, synaptophysin and CD56. The final diagnosis was small cell neuroendocrine carcinoma of right nasal cavity, pT1N0M0, stage I. INTERVENTIONS: The patient underwent wide excision of right intra-nasal tumor and post-operative radiotherapy with a dose of 6600 cGy in 33 fractions. OUTCOMES: No local recurrence or distant metastasis was noted during the 12 months of follow-up. LESSONS: Multimodality treatment remains the most common therapeutic strategy, although no proven algorithm has been established due to the rarity of this disease. Further investigation is needed for providing evidence to standardize the treatment protocol.


Assuntos
Carcinoma Neuroendócrino/patologia , Cavidade Nasal/patologia , Neoplasias Nasais/patologia , Idoso de 80 Anos ou mais , Carcinoma Neuroendócrino/radioterapia , Carcinoma Neuroendócrino/cirurgia , Feminino , Humanos , Neoplasias Nasais/radioterapia , Neoplasias Nasais/cirurgia
2.
J Laryngol Otol ; 135(10): 904-910, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34429184

RESUMO

OBJECTIVE: Sinonasal inverted papillomas are challenging benign tumours of the nasal cavity because of their high recurrence rates and the lifetime malignant transformation risk of 10 per cent as well as their locally aggressive behaviour. This study aimed to describe treatment strategies for inverted papillomas with intracranial or intraorbital involvement. METHOD: This was a prospective case series study of 18 patients with inverted papilloma with intracranial or intraorbital involvement. Patient demographic data, imaging, pathology, surgical technique and recurrences were recorded prospectively over a period of seven years. RESULTS: A total of 83 per cent of the patients in this study had been previously operated on, consisting of 8 cases with intracranial involvement, 1 case with intraorbital involvement and 9 with both. During follow up with a medium of 37 months (range, 13-115 months) there were two recurrences. CONCLUSION: It was postulated that intracranial or intraorbital involvement observed in this series was the result of multiple revisions. However, using accurate imaging protocols and the pedicle-oriented approach for tumour excision, complete tumour removal was achieved in most cases with minimal post-operative complications.


Assuntos
Endoscopia/métodos , Papiloma Invertido/diagnóstico , Papiloma Invertido/cirurgia , Neoplasias da Base do Crânio/patologia , Adulto , Idoso , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Cavidade Nasal/patologia , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Orbitárias/diagnóstico , Neoplasias Orbitárias/patologia , Neoplasias Orbitárias/cirurgia , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/cirurgia , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos
3.
Viruses ; 13(8)2021 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-34452517

RESUMO

Patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019, suffer from respiratory and non-respiratory symptoms. Among these symptoms, the loss of smell has attracted considerable attention. The objectives of this study were to determine which cells are infected, what happens in the olfactory system after viral infection, and how these pathologic changes contribute to olfactory loss. For this purpose, Syrian golden hamsters were used. First, we verified the olfactory structures in the nasal cavity of Syrian golden hamsters, namely the main olfactory epithelium, the vomeronasal organ, and their cellular components. Second, we found angiotensin-converting enzyme 2 expression, a receptor protein of SARS-CoV-2, in both structures and infections of supporting, microvillar, and solitary chemosensory cells. Third, we observed pathological changes in the infected epithelium, including reduced thickness of the mucus layer, detached epithelia, indistinct layers of epithelia, infiltration of inflammatory cells, and apoptotic cells in the overall layers. We concluded that a structurally and functionally altered microenvironment influences olfactory function. We observed the regeneration of the damaged epithelium, and found multilayers of basal cells, indicating that they were activated and proliferating to reconstitute the injured epithelium.


Assuntos
COVID-19/virologia , Células Quimiorreceptoras/virologia , Mucosa Olfatória/virologia , SARS-CoV-2 , Órgão Vomeronasal/virologia , Enzima de Conversão de Angiotensina 2/metabolismo , Animais , COVID-19/patologia , Células Quimiorreceptoras/patologia , Masculino , Mesocricetus , Cavidade Nasal/patologia , Cavidade Nasal/virologia , Mucosa Olfatória/metabolismo , Mucosa Olfatória/patologia , Neurônios Receptores Olfatórios/metabolismo , Neurônios Receptores Olfatórios/patologia , Neurônios Receptores Olfatórios/virologia , Receptores de Coronavírus/metabolismo , Regeneração , SARS-CoV-2/isolamento & purificação , Órgão Vomeronasal/metabolismo , Órgão Vomeronasal/patologia
4.
Artigo em Chinês | MEDLINE | ID: mdl-34344098

RESUMO

Objective: To summarize the preliminary experience in the treatment of esthesioneuroblastoma (ENB) and to explore the effect of age, chemotherapy, modified Kadish stage and pathological grade on the prognosis of ENB. Methods: The clinical data of 87 ENB patients from the First Affiliated Hospital of Sun Yat-sen University and Sun Yat-sen University Cancer Center between June 2002 and November 2017 were retrospectively analyzed. The modified Kadish stage was used to evaluate the extent of the lesions, and the Hyams grading system was used for pathological grading. The patients were followed up regularly to evaluate the recurrence and metastasis of the tumor. Cox proportional hazard model was used for univariate and multivariate analyses. Prognostic factors with P<0.05 in univariate analysis were included in multivariate analysis. After controlling the confounding factors, the model coefficients were used to calculate the hazard ratio (HR) and 95% confidence interval (CI). Results: The median follow-up time of ENB patients was 29 months, and the 5-year overall survival rate was 39.3%. In univariate analysis, age, chemotherapy, modified Kadish stage and pathology grade were independent predictors of overall survival, while gender, radiotherapy and surgery were not prognostic factors. Multivariate analysis showed that modified Kadish stage and pathology grade were independent predictors of overall survival rate after excluding confounding factors. Conclusions: Age, chemotherapy, modified Kadish stage and pathological grade are taking important role in the overall survival rate of patients with ENB. Modified Kadish stage and pathological grade are independent predictors of overall survival rate.


Assuntos
Estesioneuroblastoma Olfatório , Neoplasias Nasais , Estesioneuroblastoma Olfatório/patologia , Estesioneuroblastoma Olfatório/terapia , Humanos , Cavidade Nasal/patologia , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Neoplasias Nasais/patologia , Neoplasias Nasais/terapia , Prognóstico , Estudos Retrospectivos
6.
BMC Vet Res ; 17(1): 192, 2021 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-33985507

RESUMO

BACKGROUND: Histoplasma (H.) capsulatum is a dimorphic fungus, and infection is typically via inhalation of microconidia. After conversion to the yeast phase within the lung, the organism is subsequently disseminated to other tissues by macrophages. Nasal histoplasmosis appears to be a rare condition in dogs. CASE PRESENTATION: We report the clinical case of a 4.5-year-old male neutered Cocker spaniel/Poodle mix, 7.7 kg, body condition score 6/9, that presented with a 3-month history of sneezing and left-sided mucoid nasal discharge. The history also included a mild swelling (transient) of the right carpus with a lameness (grade II-III/IV), coinciding with the onset of sneezing and nasal discharge. The dog lived primarily indoors in the Texas Gulf Coast area. On physical examination, the dog was febrile, and the left nostril was swollen, ulcerative, deformed, and hypopigmented. Mandibular lymph nodes were firm and mildly enlarged bilaterally. Mild lymphopenia, thrombocytopenia, and hyperglobulinemia were noted. Thoracic radiographs were unremarkable. Computed tomography and rhinoscopy revealed swelling of the rostral portion of the left and right nasal passages. Cytology and histology of biopsies of the affected nasal tissue showed pyogranulomatous inflammation and yeast organisms consistent with H. capsulatum. Weak antigenuria was detected on the MVista H. capsulatum antigen test. Treatment with oral itraconazole led to a resolution of the nasal signs and normalization of the appearance of the nostril over 13 weeks, and neither antigenuria nor antigenemia was detected on several recheck examinations. The dog remained in good general and physical condition and showed no signs of disease recurrence more than 6 years after the last examination. CONCLUSION: We report a rare case of nasal mucocutaneous histoplasmosis in an immunocompetent dog, with an excellent clinical response to oral itraconazole. This case documents that histoplasmosis in dogs can affect primarily the nasal cavity, which responds rapidly to triazole antifungal therapy and has a good prognosis. A similar case has only been reported in human medicine in a young adult.


Assuntos
Doenças do Cão/microbiologia , Histoplasmose/veterinária , Cavidade Nasal/microbiologia , Animais , Antifúngicos/uso terapêutico , Doenças do Cão/tratamento farmacológico , Cães , Histoplasma/imunologia , Histoplasma/isolamento & purificação , Histoplasmose/tratamento farmacológico , Histoplasmose/patologia , Itraconazol/uso terapêutico , Masculino , Cavidade Nasal/patologia , Texas
7.
Int Arch Allergy Immunol ; 182(8): 690-696, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34000723

RESUMO

INTRODUCTION: While there exists considerable evidence for efficacy of sublingual immunotherapy (SLIT), its impact on the improvement of nasal signs in allergic rhinitis (AR) patients remains quite unclear. In this study, the endoscopic examination and the modified Lund-Kennedy (MLK) scoring system were performed to describe and evaluate the therapeutic effect of SLIT. METHODS: A total of 105 patients with AR induced by house dust mites were enrolled and treated with standardized Dermatophagoides farinae (D. farinae) drops for 1 year. The total nasal symptoms score (TNSS), total medication score (TMS), visual analog scale (VAS), and MLK scores were assessed at baseline and 6 and 12 months. The MLK score was also compared for its correlation with TNSS, TMS, and VAS. RESULTS: The TNSS, TMS, and VAS scores statistically decreased after SLIT compared to baseline (all p < 0.05). After 12 months of treatment, the rates of well-controlled, partial controlled, and uncontrolled AR patients were 42, 49.5, and 8.5%, respectively. The nasal endoscopy findings showed significant improvement in nasal signs, which mainly included color change of turbinate mucosa, reduction of nasal secretions, and improvement of nasal edema. A significant decrease was observed in MLK scores, and there was a positive correlation between MLK and VAS scores. CONCLUSIONS: In addition to commonly utilized subjective assessments (TMS, TNSS, and VAS), our results of endoscopic examination and the MLK scores consistently confirmed that SLIT is an effective therapeutic modality for AR patients. The MLK scores might be considered as an auxiliary tool to evaluate efficacy of SLIT in clinical practice and outcomes research.


Assuntos
Alérgenos/imunologia , Endoscopia , Pyroglyphidae/imunologia , Rinite Alérgica/diagnóstico , Rinite Alérgica/etiologia , Rinite Alérgica/terapia , Imunoterapia Sublingual , Animais , Antígenos de Dermatophagoides/imunologia , Tomada de Decisão Clínica , Gerenciamento Clínico , Endoscopia/métodos , Humanos , Cavidade Nasal/diagnóstico por imagem , Cavidade Nasal/patologia , Índice de Gravidade de Doença , Imunoterapia Sublingual/métodos
8.
Open Vet J ; 11(1): 1-5, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33898276

RESUMO

Background: Primary neoplasms of the nasal cavity and sinuses are uncommon in domestic animals, most of which are of epithelial origin, being adenocarcinoma the most common tumor diagnosed in this region. Some malignant nasal cavity neoplasms may invade the brain causing clinical neurological signs, as well as purulent nasal secretion and epistaxis. Case Description: A case of neoplasm is reported in a 14-year-old pincher presenting dyspnea, epistaxis, and neurological alterations. Necropsy revealed the presence of a mass in the oral cavity vestibule, and another in the whole nasal cavity with invasion of the cribiform plate, meninges and brain. Squamous cells carcinoma was diagnosed in the oral cavity and transitional carcinoma in the nasal cavity. The immunohistochemistry confirmed that the brain infiltration was of the same origin as the nasal cavity neoplasm. Conclusion: The present report describes a rare case of transitional carcinoma of the nasal cavity as well as the frontal and ethmoidal sinuses with brain invasion, confirmed by immunohistochemistry. It is extremely important for veterinarians to include neoplasms in their differential diagnoses, when these animals show chronic respiratory signs and neurological alterations that do not improve with appropriate treatment, always associating with complementary exams, for correct diagnosis establishment and prognosis formulation.


Assuntos
Neoplasias Encefálicas/veterinária , Carcinoma de Células Escamosas/veterinária , Carcinoma de Células de Transição/veterinária , Doenças do Cão/patologia , Neoplasias Bucais/veterinária , Neoplasias Nasais/veterinária , Animais , Neoplasias Encefálicas/secundário , Carcinoma de Células Escamosas/patologia , Carcinoma de Células de Transição/diagnóstico , Carcinoma de Células de Transição/patologia , Doenças do Cão/diagnóstico , Cães , Seio Etmoidal/patologia , Meninges/patologia , Neoplasias Bucais/patologia , Cavidade Nasal/patologia , Metástase Neoplásica , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/patologia
9.
Artigo em Chinês | MEDLINE | ID: mdl-33794606

RESUMO

Objective:To explore the therapeutic effect and prognostic risk factors of olfactory neuroblastoma. Methods:Retrospective analysis of clinical data of 31 patients with olfactory neuroblastoma. The Kaplan-Meier method was used for survival analysis to calculate the overall survival rate and progress-free survival rate. Results:All 31 patients underwent surgical treatment and 7 patients died, of which 4 patients died of simple intracranial invasion and 3 patients died of concurrent distant metastasis (lung and spinal cord). The average death time was 40.7 (20-57) months. Statistical analysis showed that craniocerebral invasion (P=0.035), age ≥60 years (P=0.042), and Ki-67≥20%(P=0.018) were closely related to the poor prognosis. It is speculated that the increase of T staging and modified Kadish staging are also predictors of poor prognosis. The 1-year and 5-year overall survival rates were 100.0% and 72.5%, and the 1-year and 5-year progress-free survival rates were 87.8% and 33.6% after first surgery. Conclusion:Surgery combined with radiotherapy and chemotherapy are the main treatments for olfactory neuroblastoma, but postoperative recurrence and metastasis are common. About 22.6% of the patients died during the follow-up. Advanced age, intracranial invasion and Ki-67≥20% are closely related to poor prognosis. The tumor was completely removed by the initial surgery and restricted in nasal cavity and sinuses are the key factors for a good prognosis.


Assuntos
Estesioneuroblastoma Olfatório , Neoplasias Nasais , Estesioneuroblastoma Olfatório/patologia , Humanos , Pessoa de Meia-Idade , Cavidade Nasal/patologia , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Neoplasias Nasais/patologia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
10.
Artigo em Chinês | MEDLINE | ID: mdl-33794633

RESUMO

Objective:To investigate the clinical characteristics and prognostic factors of esthesioneuroblastoma. Methods:The clinical data of 31 patients with esthesioneuroblastoma were retrospectively studied. Results:The average time from first onset to diagnosis in 31 patients was 7.84 months, among which 3 patients(9.68%) had cervical lymph node metastasis at the first visit. By the end of follow-up, there were 25 coexisting cases and 6 deaths. The mean recurrence time of 6 patients was 10.6 months. There were 6 patients with distant metastasis, including 4 patients with cervical lymph node metastasis, 1 patient with liver metastasis and 1 patient with bone metastasis. Modified Kadish stage, different treatment methods, recurrence, first diagnosis of cervical lymph node metastasis, and distant metastasis were all factors affecting the prognosis of the patients. Conclusion:The incidence of esthesioneuroblastoma is low and the comprehensive treatment of surgery combined with radiotherapy is the optimal treatment plan. Patients with low Kadish staging, surgical combined with radiotherapy, no recurrence, no initial cervical lymph node metastasis, and no distant metastasis have a better prognosis.


Assuntos
Estesioneuroblastoma Olfatório , Neoplasias Nasais , Estesioneuroblastoma Olfatório/diagnóstico , Estesioneuroblastoma Olfatório/patologia , Estesioneuroblastoma Olfatório/terapia , Humanos , Linfonodos/patologia , Cavidade Nasal/patologia , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/patologia , Neoplasias Nasais/terapia , Prognóstico , Estudos Retrospectivos
11.
Sci Rep ; 11(1): 6842, 2021 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-33767236

RESUMO

C407 is a compound that corrects the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) protein carrying the p.Phe508del (F508del) mutation. We investigated the corrector effect of c407 and its derivatives on F508del-CFTR protein. Molecular docking and dynamics simulations combined with site-directed mutagenesis suggested that c407 stabilizes the F508del-Nucleotide Binding Domain 1 (NBD1) during the co-translational folding process by occupying the position of the p.Phe1068 side chain located at the fourth intracellular loop (ICL4). After CFTR domains assembly, c407 occupies the position of the missing p.Phe508 side chain. C407 alone or in combination with the F508del-CFTR corrector VX-809, increased CFTR activity in cell lines but not in primary respiratory cells carrying the F508del mutation. A structure-based approach resulted in the synthesis of an extended c407 analog G1, designed to improve the interaction with ICL4. G1 significantly increased CFTR activity and response to VX-809 in primary nasal cells of F508del homozygous patients. Our data demonstrate that in-silico optimized c407 derivative G1 acts by a mechanism different from the reference VX-809 corrector and provide insights into its possible molecular mode of action. These results pave the way for novel strategies aiming to optimize the flawed ICL4-NBD1 interface.


Assuntos
Brônquios/efeitos dos fármacos , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Fibrose Cística/tratamento farmacológico , Homozigoto , Cavidade Nasal/efeitos dos fármacos , Ácidos Fosfínicos/química , Ácidos Fosfínicos/farmacologia , Brônquios/metabolismo , Brônquios/patologia , Células Cultivadas , Fibrose Cística/genética , Fibrose Cística/patologia , Humanos , Simulação de Acoplamento Molecular , Mutação , Cavidade Nasal/metabolismo , Cavidade Nasal/patologia
12.
Medicine (Baltimore) ; 100(12): e25165, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33761691

RESUMO

RATIONALE: Rosai-Dorfman disease (RDD) is a rare and self-limiting condition caused by the non-neoplastic proliferation of histiocytes/phagocytes in the sinusoids of lymph nodes and in extranodal tissues. Of the extranodal involvement, laryngeal involvement is extremely rare. Because of its rarity and nonspecific clinicoradiologic features, RDD is often difficult to differentiate from other benign or malignant lymphoproliferative diseases. We present a case of RDD with infiltration of IgG4-bearing plasma cells manifesting laryngeal and nasal masses with cervical lymphadenopathy. PATIENT CONCERNS: A 45-year-old male patient presented with recurrent epistaxis and airway disturbance. DIAGNOSES: On endoscopy, there were submucosal masses in both nasal cavities and both sides of subglottic larynx. On neck CT, there were well-defined, enhancing soft tissue masses in both nasal cavities and both sides of subglottic larynx, resulting in mild airway narrowing. In addition, multiple enlarged lymph nodes showing homogeneous enhancement were noted in both parotid glands and both internal jugular chains. All lesions demonstrated marked FDG-uptake on PET/CT. Therefore, the initial radiologic differential diagnoses included lymphoma and IgG4-related disease. Biopsy was performed on the nasal and laryngeal lesions, and they revealed RDD with infiltration of IgG4-bearing plasma cells. INTERVENTION: The patient underwent surgical resection of the masses in the nasal cavity and larynx to relieve airway narrowing. OUTCOMES: After surgery, airway obstruction was much improved and the patient was asymptomatic. On outpatient follow-up, he exhibited a stable condition and had no dyspnea on exercise. LESSONS: Clinical awareness and suspicion are important for the accurate diagnosis and management of patients with homogeneous masses in the larynx or nasal cavity, even if there is no combined cervical lymphadenopathy.


Assuntos
Histiocitose Sinusal/imunologia , Histiocitose Sinusal/patologia , Imunoglobulina G/imunologia , Laringe/patologia , Linfadenopatia/patologia , Cavidade Nasal/patologia , Plasmócitos/imunologia , Obstrução das Vias Respiratórias/etiologia , Obstrução das Vias Respiratórias/cirurgia , Biópsia , Diagnóstico Diferencial , Endoscopia , Epistaxe/etiologia , Radioisótopos de Flúor , Histiocitose Sinusal/complicações , Histiocitose Sinusal/cirurgia , Humanos , Laringe/cirurgia , Linfadenopatia/etiologia , Linfadenopatia/cirurgia , Masculino , Pessoa de Meia-Idade , Cavidade Nasal/cirurgia , Pescoço , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Recidiva
13.
Clin Nucl Med ; 46(7): e378-e380, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33782294

RESUMO

ABSTRACT: Esthesioneuroblastoma is a rare malignant tumor arising from olfactory neuroepithelium. PET/CT with different tracers such as 18F-FDG and 68Ga-somatostatin-receptor tracers has demonstrated its utility for the evaluation of disease. We present the case of a woman previously treated for esthesioneuroblastoma performing MR and 18Ga-DOTATOC PET/CT demonstrating dural metastasis of disease with a strong correspondence between conventional and functional imaging.


Assuntos
Estesioneuroblastoma Olfatório/patologia , Carcinomatose Meníngea/diagnóstico por imagem , Carcinomatose Meníngea/secundário , Cavidade Nasal/patologia , Neoplasias Nasais/patologia , Compostos Organometálicos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Feminino , Humanos , Pessoa de Meia-Idade
14.
Rev. esp. patol ; 54(1): 59-64, ene.-mar. 2021. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-202491

RESUMO

El carcinoma epidermoide sarcomatoide es una entidad rara en la fosa nasal. Presentamos el caso de un varón de 50 años con una masa polipoide en la cavidad nasal izquierda. En el estudio anatomopatológico, se observa una histología bifásica de nidos escamosos no queratinizantes y un estroma sarcomatoide con positividad para AE1-AE3. El paciente presentó metástasis cervicales ipsilaterales, tratándose con vaciamiento cervical, radioterapia y cisplatino adyuvante. Dos años después se encuentra libre de enfermedad


Spindle cell carcinoma of the nasal cavity is a rare variant of squamous cell carcinoma. We report a case of a 50 year-old male presenting with a polypoid mass in the left nasal cavity. Histologically, the tumor was biphasic, composed of non-keratinizing squamous nests and a sarcomatoid stroma with positivity for CKAE1-AE3. Metastatic ipsilateral lymph nodes were present and the patient underwent radical neck dissection, followed by adjuvant radiotherapy and cisplatin. Two years after diagnosis the patient is free of disease


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Carcinossarcoma/patologia , Neoplasias Nasais/patologia , Cavidade Nasal/patologia , Metástase Neoplásica/patologia , Carcinossarcoma/diagnóstico , Metástase Neoplásica/tratamento farmacológico , Metástase Neoplásica/radioterapia , Intervalo Livre de Doença , Imuno-Histoquímica
16.
Laryngoscope ; 131(2): E428-E433, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32207858

RESUMO

OBJECTIVES/HYPOTHESIS: Recent developments in reconstructive techniques for mucosal defects using mucoperiosteal materials have enabled rapid recovery of physiological function after endoscopic sinus surgery. Clinical trials have described the advantages, disadvantages, and different outcomes of free graft and pedicled flap, which, respectively, sacrifice or preserve blood flow. However, histological changes, that affect the postoperative outcomes after reconstruction, remain unclear. We created an animal model for the reconstruction of mucosal defects using free grafts and pedicled flaps, and evaluated them histologically. STUDY DESIGN: Animal study. METHODS: We created mucosal defects in the left nasal septum of 20 rabbits and performed reconstruction with free grafts and pedicled flaps. The distribution of ciliary and goblet cells at the reconstruction site was evaluated after 7 and 28 days using hematoxylin and eosin-stained sections to calculate the Ciliary Cell Index and Goblet Cell Index. The severity of inflammation was assessed using the Cartilage Inflammatory Cell Score. RESULTS: Crusting and changes in the mucosal morphology at the reconstruction site occurred only in the free graft group. In addition, the pedicled flap group had significantly greater preservation of ciliary and goblet cells and less inflammatory cell infiltration into the septal cartilage (P < .05) than the free graft group. CONCLUSIONS: After reconstruction procedures for mucosal defects, histopathological differences were observed between the free graft and pedicled flap. Reconstruction with pedicled flaps had advantages including preservation of healthy mucosal epithelium and suppression of inflammation on the reconstruction site. This indicated that reconstruction with pedicled flaps might have advantages over that with free grafts. LEVEL OF EVIDENCE: NA Laryngoscope, 131:E428-E433, 2021.


Assuntos
Retalhos de Tecido Biológico/cirurgia , Cavidade Nasal/cirurgia , Retalhos Cirúrgicos/cirurgia , Animais , Retalhos de Tecido Biológico/patologia , Masculino , Cavidade Nasal/patologia , Mucosa Nasal/patologia , Mucosa Nasal/cirurgia , Coelhos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Retalhos Cirúrgicos/patologia
17.
EBioMedicine ; 63: 103153, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33279857

RESUMO

BACKGROUND: The novel human coronavirus SARS-CoV-2 is a major ongoing global threat with huge economic burden. Like all respiratory viruses, SARS-CoV-2 initiates infection in the upper respiratory tract (URT). Infected individuals are often asymptomatic, yet highly infectious and readily transmit virus. A therapy that restricts initial replication in the URT has the potential to prevent progression of severe lower respiratory tract disease as well as limiting person-to-person transmission. METHODS: SARS-CoV-2 Victoria/01/2020 was passaged in Vero/hSLAM cells and virus titre determined by plaque assay. Challenge virus was delivered by intranasal instillation to female ferrets at 5.0 × 106 pfu/ml. Treatment groups received intranasal INNA-051, developed by Ena Respiratory. SARS-CoV-2 RNA was detected using the 2019-nCoV CDC RUO Kit and QuantStudio™ 7 Flex Real-Time PCR System. Histopathological analysis was performed using cut tissues stained with haematoxylin and eosin (H&E). FINDINGS: We show that prophylactic intra-nasal administration of the TLR2/6 agonist INNA-051 in a SARS-CoV-2 ferret infection model effectively reduces levels of viral RNA in the nose and throat. After 5 days post-exposure to SARS-CoV-2, INNA-051 significantly reduced virus in throat swabs (p=<0.0001) by up to a 24 fold (96% reduction) and in nasal wash (p=0.0107) up to a 15 fold (93% reduction) in comparison to untreated animals. INTERPRETATION: The results of our study support clinical development of a therapy based on prophylactic TLR2/6 innate immune activation in the URT, to reduce SARS-CoV-2 transmission and provide protection against COVID-19. FUNDING: This work was funded by Ena Respiratory, Melbourne, Australia.


Assuntos
Lipopeptídeos/administração & dosagem , Sistema Respiratório/virologia , SARS-CoV-2/patogenicidade , Receptor 2 Toll-Like/agonistas , Receptor 6 Toll-Like/agonistas , Eliminação de Partículas Virais , Administração Intranasal , Animais , COVID-19/tratamento farmacológico , COVID-19/patologia , Modelos Animais de Doenças , Feminino , Furões , Imunidade Inata , Lipopeptídeos/química , Lipopeptídeos/farmacologia , Cavidade Nasal/patologia , Cavidade Nasal/virologia , Faringe/patologia , Faringe/virologia , RNA Viral/metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Sistema Respiratório/patologia , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Carga Viral/efeitos dos fármacos
18.
Otolaryngol Head Neck Surg ; 164(6): 1337-1344, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33045908

RESUMO

OBJECTIVE: This study aimed to investigate the differences in olfactory cleft (OC) morphology in coronavirus disease 2019 (COVID-19) anosmia compared to control subjects and postviral anosmia related to infection other than severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). STUDY DESIGN: Prospective. SETTING: This study comprises 91 cases, including 24 cases with anosmia due to SARS-CoV-2, 38 patients with olfactory dysfunction (OD) due to viral infection other than SARS-CoV-2, and a control group of 29 normosmic cases. METHODS: All cases had paranasal sinus computed tomography (CT), and cases with OD had magnetic resonance imaging (MRI) dedicated to the olfactory nerve. The OC width and volumes were measured on CT, and T2-weighted signal intensity (SI), olfactory bulb volumes, and olfactory sulcus depths were assessed on MRI. RESULTS: This study showed 3 major findings: the right and left OC widths were significantly wider in anosmic patients due to SARS-CoV-2 (group 1) or OD due to non-SARS-CoV-2 viral infection (group 2) when compared to healthy controls. OC volumes were significantly higher in group 1 or 2 than in healthy controls, and T2 SI of OC area was higher in groups 1 and 2 than in healthy controls. There was no significant difference in olfactory bulb volumes and olfactory sulcus depths on MRI among groups 1 and 2. CONCLUSION: In this study, patients with COVID-19 anosmia had higher OC widths and volumes compared to control subjects. In addition, there was higher T2 SI of the olfactory bulb in COVID-19 anosmia compared to control subjects, suggesting underlying inflammatory changes. There was a significant negative correlation between these morphological findings and threshold discrimination identification scores. LEVEL OF EVIDENCE: Level 4.


Assuntos
Anosmia/patologia , Anosmia/virologia , COVID-19/complicações , Cavidade Nasal/patologia , Bulbo Olfatório/patologia , Adulto , Anosmia/diagnóstico por imagem , COVID-19/diagnóstico por imagem , COVID-19/patologia , Estudos de Casos e Controles , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Cavidade Nasal/diagnóstico por imagem , Bulbo Olfatório/diagnóstico por imagem , Mucosa Olfatória/diagnóstico por imagem , Mucosa Olfatória/patologia , Tamanho do Órgão , Estudos Prospectivos , Tomografia Computadorizada por Raios X
19.
Autops. Case Rep ; 11: e2021246, 2021. graf
Artigo em Inglês | LILACS | ID: biblio-1153187

RESUMO

Extranodal NK/T-cell lymphoma, nasal type (ENKTL-NT) is a rare type of Non-Hodgkin's lymphoma, which usually presents with extranodal involvement and affects the nasal/upper aerodigestive tract in the classical presentation. Herein, we report the case of a 31-year-old, previously healthy, male patient diagnosed with ENKTL-NT with the involvement of the lung parenchyma and heart. Unfortunately, due to the rapid disease progression, the diagnosis was performed only at the autopsy. The authors highlight the rare clinical presentation of this type of lymphoma, as well as the challenging anatomopathological diagnosis in necrotic samples.


Assuntos
Humanos , Masculino , Adulto , Neoplasias Nasais/patologia , Linfoma Extranodal de Células T-NK/patologia , Cavidade Nasal/patologia , Autopsia , Linfoma de Células T , Evolução Fatal , Herpesvirus Humano 4 , Progressão da Doença , Coração , Pulmão/patologia
20.
Rev. esp. patol ; 53(4): 257-263, oct.-dic. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-200573

RESUMO

Extraosseous (extramedullary) plasmacytomas are rare plasma cell neoplasms that can result in an erroneous and/or delayed diagnosis as often they are not considered in the differential diagnosis due to their rarity. Furthermore, the anaplastic type is one of the most difficult to recognize in biopsies. We report the case of a patient with an extraosseous plasmacytoma occluded in the right nostril. Its prompt and accurate diagnosis resulted in early treatment and a good outcome, despite the tumour being anaplastic with the risk of progressing into a plasma cell myeloma. The patient shows no recurrence or disease progression after 10 years of follow-up. Our case highlights the clinical and pathological characteristics of this rare disorder that should be considered in order to improve diagnostic criteria and thus early treatment. We also reviewed the pertinent literature


Los plasmocitomas extraóseos (extramedulares) son neoplasias de células plasmáticas que a menudo resultan en diagnósticos erróneos y/o retrasados, debido a que con poca frecuencia se consideran dentro del diagnóstico diferencial y donde el tipo anaplásico es una de las formas más difíciles de reconocer en las biopsias. Aquí describimos el caso de un paciente con un plasmocitoma extraóseo ocluido en la fosa nasal derecha, donde el diagnóstico oportuno y adecuado permitió proporcionar un tratamiento temprano con buenos resultados a pesar de ser un tipo anaplásico con riesgo de progresar a mieloma de células plasmáticas. El seguimiento de 10 años después del diagnóstico mostró que el paciente experimentó una respuesta completa sin recurrencia o progresión de la enfermedad. Nuestro caso destaca las características clínicas y patológicas que los médicos deben considerar al tratar a pacientes con esta enfermedad infrecuente para mejorar los criterios de diagnóstico y proporcionar un tratamiento más oportuno


Assuntos
Humanos , Masculino , Adulto , Plasmocitoma/patologia , Neoplasias Nasais/patologia , Cavidade Nasal/patologia , Neoplasias de Plasmócitos/patologia , Recidiva Local de Neoplasia/patologia , Plasmocitoma/radioterapia
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