Basal cell adenoma of the parotid. An ultrastructural study

The monomorphic basal cell adenoma of parotid gland is a rare tumor of salivary glands. Its diagnosis is difficult with adenoid cystic carcinoma. In the case reported here, a peculiar type named membranous adenoma, the thickness of basement membranes, their penetration inside the epithelial lobules, form true cylinders as in adenoid cystic carcinoma. The histoenzymology and the electron microscopy provide important diagnostic arguments: activity of alkaline phosphatases lower than in cystic adenoid carcinoma; cells of adenoma more differentiated (epidermoid or secretory cells) than those of cystic adenoid carcinoma. The prognosis of the tumor is good, though recurrences may occur.     

Zystische Raumforderung der Halsweichteile: cave Echinokokkose

The diagnosis of cystic echinococcosis (echinococcus granulosus) in an atypical location can be difficult to make and frequently can only be established by histological examination of affected tissues. Surgical excision and fine-needle aspiration biopsy usually lead to the diagnosis. Since puncture of these cysts may cause an anaphylactic reaction due to spillage of hydatid fluid and/or dissemination of infection, the use of fine-needle aspiration biopsy is controversial at present. We report on a patient with a cystic neck mass who developed an allergic reaction after diagnostic fine-needle aspiration biopsy. Cytological examination of the specimen was inconclusive. The allergic reaction led to the diagnosis of echinococcosis, which was confirmed by serological examination. We describe a possible diagnostic procedure for a cystic mass of unknown etiology. If imaging and serological tests are not conclusive, we believe that fine-needle aspiration biopsy is justified. However, this should only be performed in a setting that provides sufficient management for anaphylactic reactions.     

Cystic papillary carcinoma of thyroid gland — A rare case

A case of cystic papillary carcinoma of thyroid gland is reported, which depicts typical ultrasonographic features that help in diagnosing a rare case with diagnostic certainty.     

Differential diagnosis of pleomorphic adenoma by immunohistochemical means.

Immunohistochemical study of major salivary gland tumours was performed on 60 pleomorphic adenomas, five basal cell adenomas and 10 adenoid cystic carcinomas to determine the diagnostic value of each antigen. Immunoreactivity examined were intermediate filaments (keratin, vimentin, desmin and glial fibrillary acidic protein [GFAP]) and related substances (actin, S-100 protein and secretory component). In pleomorphic adenomas, there was positive immunoreactivity for GFAP which was not observed in normal tissue or other neoplastic tissues. Immunoreactivity of GFAP was closely related to myxomatous and early chondromatous differentiation in pleomorphic adenoma. It is considered that GFAP immunoreactivity should be assessed in the occasional differential diagnostic dilemma of pleomorphic adenoma versus adenoid cystic carcinoma and basal cell adenoma, because of its ability to show potential and definite myxochondromatous differentiation.     

A new case of pediatric laryngeal foraminal cyst: Diagnostic challenges and association with hemi-facial microsomia

Laryngeal cysts are heterogeneous in their clinical presentation and several classifications have been proposed. Here, we report the case of a foraminal laryngeal cyst in a 6 year-old child who also has hemi facial microsomia (HFM). The cyst was treated surgically with laryngotracheal endoscopy followed by cervicotomy. Histological analysis revealed different types of cystic wall epithelium. This case is the first report of a laryngeal cyst associated with HFM in the literature. We discuss the diagnostic challenges of these specific cystic pathologies, and their pathogenesis as part of an oculo-auriculo-vertebral spectrum. Several hypotheses are proposed, based mainly on characterization of their embryological origin.     

Diagnostic utility of positron emission tomography-computed tomography for predicting malignancy in cystic neck masses in adults

OBJECTIVES: Combined positron emission tomography and computed tomography (PET-CT) is used for the diagnostic evaluation and staging of squamous cell carcinoma of the head and neck (SCCHN). By superimposing anatomic localization of CT with the physiologic data of PET, occult primary and metastatic neoplasms might be identified. Because the diagnostic algorithm for cystic neck masses in adults often overlaps with the work-up of cancer of unknown primary site, we evaluated the utility of PET-CT scans to identify the presence of malignancy and the location of primary tumor. STUDY DESIGN: Single-institution retrospective case review series. METHODS: We reviewed the PET-CT imaging of cystic neck masses occurring in five patients over 40 years of age with significant risk factors for SCCHN and correlated this information with histopathology. RESULTS: In each patient in our series, the PET portion of a combined PET-CT was misleading, whereas the CT examination was more suggestive of the correct pathology. Ultimately, clinical judgment and endoscopic evaluation, guided by CT findings, were most valuable for distinguishing malignant versus benign processes and identifying the primary tumor sites. CONCLUSIONS: PET-CT may not be a reliable modality for identifying malignancy in adults with suspicious cystic neck masses. A thorough clinical evaluation by an experienced head and neck surgeon, in conjunction with contrast-enhanced CT, may be sufficient to facilitate the optimal management of such patients.     

Bilateral parotid enlargement in HIV-Seropositive patients

Bilateral enlargement of the parotid glands has been noted in five patients who are seropositive for antibody to the human immunodeficiency virus. A characteristic cystic appearance has been noted in these lesions on clinical and radiographic examination. A benign lymphoepithelial infiltrate with cystic degeneration is found in parotid specimens from these patients. The presence of human immunodeficiency virus ribonucleic acid in inflammatory cells infiltrating the parotid specimen was confirmed by an in situ hybridization technique. The clinical manifestations of sicca syndrome were not present nor were opportunistic infections diagnostic for the acquired immunodeficiency syndrome.     

Cystic form of cervical lymphadenopathy. Guidelines of the French Society of Otorhinolaryngology - Head and Neck Surgery (SFORL). Part 1: Diagnostic procedures for lymphadenopathy in case of cervical mass with cystic aspect

ObjectivesThe authors present the guidelines of the French Society of Otorhinolaryngology - Head and Neck Surgery Society on diagnostic procedures for lymphadenopathy in case of a cervical mass with cystic aspect.MethodsA multidisciplinary work-group was entrusted with a review of the scientific literature on the topic. Guidelines were drawn up, then read over by an editorial group independent of the work-group, and the final version was drawn up. Guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence.ResultsIn adults presenting a cystic cervical mass, it is recommended to suspect cervical lymphadenopathy: in order of decreasing frequency, cystic metastasis of head and neck squamous cell carcinoma, of undifferentiated nasopharyngeal carcinoma, and of thyroid papillary carcinoma (Grade C). On discovery of a cystic cervical mass on ultrasound, architectural elements indicating a lymph node and a thyroid nodule with signs of malignancy should be screened for, especially if the mass is located in levels III, IV or VI (Grade A). Malignant lymphadenopathy should be suspected in case of cervical mass with cystic component on CT (Grade B), but benign or malignant status cannot be diagnosed only on radiological data (CT or MRI) (Grade A), and 18-FDG PET-CT should be performed, particularly in case of inconclusive ultrasound-guided fine needle aspiration biopsy (Grade C).     

Invasion of the recurrent laryngeal nerve by adenoid cystic carcinoma. An unusual cause of true vocal fold paralysis.

True vocal fold paralysis and goitre are both common problems encountered in ENT practice. Their co-existence, however, should arouse suspicion of the presence of malignant thyroid disease. A rare case of true vocal fold paralysis caused by a clinically occult subglottic adenoid cystic carcinoma, in a 72-year-old, is described. The existence of multinodular goitre in this patient was co-incidental and confounded the diagnostic process.     

成人侧颈区孤立囊性肿块的诊断

目的 收集初诊为成人侧颈区良性囊肿患者的临床病理学资料,探讨良恶性的鉴别要点,提高术前诊断准确性。方法 回顾性分析2014年1月—2021年12月北京友谊医院耳鼻咽喉头颈外科诊治的成年患者,初步诊断为鳃裂囊肿或囊性水瘤。总结分析患者的临床、影像学以及病理学资料。结果 共37例初诊为颈部良性囊肿的患者中,最终总恶性率为13.5%(5/37),其中口咽鳞状细胞癌颈淋巴结转移2例,甲状腺乳头状癌颈淋巴结转移3例。颈部肿块存在分隔或囊壁局限性增厚是成人侧颈区孤立囊性肿块最终诊断为颈部淋巴结转移癌的独立危险预测因素(P<0.05)。结论 成人孤立侧颈区囊性肿块需要警惕为颈部不明原发灶转移癌。对于成人侧颈区孤立囊性肿块,尤其当颈部肿块存在分隔或囊壁局限性增厚时,需要结合多种诊断方法,排除颈部不明原发灶转移癌。     

Primary hydatid cyst of the neck

Hydatid cysts in the cervicofacial region are rare. We present an unusual case of a hydatid cyst found in the nape of a 66-year-old Turkish woman. There was no pulmonary or hepatic involvement. Excision of the cystic mass as definitive therapy was performed. The location of the lesion, diagnostic tests available and therapeutic approach are discussed and the literature reviewed. Received: 25 June 1998 / Accepted: 14 October 1998     

Noninflammatory, non-neoplastic disorders of the salivary glands.

Noninflammatory, non-neoplastic diseases comprise a diverse group of disorders that can present in a variety of ways. In general, a careful history will sharply focus the diagnostic possibilities. Although the diagnosis usually will be certain following the physical examination, additional testing may be needed to facilitate treatment planning. Sialolithiasis, cystic lesions, radiation injury, treatment to the parotid glands, sialodenosis, and other disorders are discussed in this article.     

Extrafollicular Adenomatoid odontogenic tumour presenting as a periapical lesion: Report of a rare entity

Adenomatoid odontogenic tumour (AOT) has been known to the pathologists for the past 100 years as a benign slow growing tumour. Histologically, this tumour has a predominantly solid component and very few case reports have described the cystic nature of AOT. In the present case we review the literature of extrafollicular AOT presenting as a periapical disease and add to the literature a case of cystic extrafollicular AOT in a 17-year-old patient, initially diagnosed as a radicular cyst. Radiographically extrafollicular AOT frequently resembles other odontogenic lesions such as residual, developmental lateral periodontal or radicular cyst, however histopathological findings of this tumour are quite characteristic and present few diagnostic problems. Correlation of clinical and radiological information with histological features is important in the diagnosis of odontogenic cysts and tumours, to decrease the incidence of misdiagnosis for such cases and this in turn will help in preventing recurrences.     

鼻腔鼻窦腺样囊性癌88例临床分析

目的 总结鼻腔鼻窦腺样囊性癌的临床特征和治疗方法,探讨影响鼻腔鼻窦腺样囊性癌患者预后的因素.方法 总结中山大学肿瘤防治中心头颈外科1975年11月至2003年8月收治的88例原发于鼻腔鼻窦的腺样囊性癌患者的临床及病理资料,回顾性分析单纯手术、单纯放疗与放疗结合手术、化疗等治疗方式的疗效.对其治疗与预后进行统计分析.生存分析采用Kaplan-Meier法,组间比较采用Log-rank检验,多因素分析采用Cox比例风险模型.结果 就诊时56例鼻腔鼻窦腺样囊性癌患者为Ⅲ、Ⅳ期病变,治疗多采用手术+放疗.全组患者的5年、10年、15年生存率分别为0.640、0.341、0.190;Ⅲ期患者的5年、10年生存率分别为0.833、0.221;Ⅳ期患者的5年、10年生存率分别为0.323、0.145.手术+放疗组、单纯手术组及单纯放疗组的5年、10年生存率分别为0.761、0.415,0.750、0.367,0.286、0.143.结论 鼻腔鼻窦腺样囊性癌的治疗应以综合治疗为主,临床分期及治疗方式是影响鼻腔鼻窦腺样囊性癌患者预后的独立因素.     

Thymic cyst in the neck

A rare case of a thymic cyst in the neck containing both thymus and parathyroid tissue in a 7-year-old boy is presented. The clinical presentation, diagnostic evaluation, surgical management and histopathological features are described. The embryology of cervical thymic cysts and the differential diagnosis of cystic neck masses in children are briefly reviewed. The diagnosis is seldom made preoperatively. Surgical resection is the treatment of choice for definitive diagnosis, resolution of symptoms and cure.     

Thymic cyst in the neck

A rare case of a thymic cyst in the neck containing both thymus and parathyroid tissue in a 7-year-old boy is presented. The clinical presentation, diagnostic evaluation, surgical management and histopathological features are described. The embryology of cervical thymic cysts and the differential diagnosis of cystic neck masses in children are briefly reviewed. The diagnosis is seldom made preoperatively. Surgical resection is the treatment of choice for definitive diagnosis, resolution of symptoms and cure.     

The radiologic diagnosis of pneumocele of the maxillary sinus.

Pneumocele of the maxillary sinus is a recently described disease, first noted in 1974. Three subsequent cases have been encountered. Pneumocele refers to an expansile cystic air-containing mass, occupying the entire maxillary sinus, and lined by the original attenuated mucous membrane. It is analogous to mucocele, but containing air rather than fluid content. Radiologic signs are diagnostic, and it is the purpose of this presentation to enumerate these radiologic findings.     

Cholesterol cyst manifesting as a middle ear vascular tumor

A localized, cystic, "blue ear drum" (idiopathic hymotympanum) mimicking a middle ear vascular tumor occurred in a 12-year-old boy. This lesion must be included in the differential diagnosis of suspected vascular mass of the middle ear. A history of eustachian tube dysfunction should be sought. Physical examination is usually not diagnostic, and a full radiologic evaluation is essential in order to rule out a high jugular bulb, an ectopic carotid artery, or a glomus tumor.     

Solitary bone cyst. A case of dual mandibular and humeral location

Among cystic lesions of maxilla the solitary bone cyst always raises diagnostic and etiopathogenic problems. Typically observed as single lesions in maxilla, reports have been published of multiple localizations. Similitudes with solitary cyst of long bones have even been underlined, but no reports exist in the literature of the double localization: maxillary and extra-maxillary. A young man presented mandibular and humeral lesions possessing characteristics of solitary bone cysts.     

Atypische Mukoviszidose

We present the case of a 44-year-old wrestler suffering from persistent bronchitis and chronic rhinosinusitis which had been refractory to therapy. The patient underwent extensive diagnostic examinations throughout the disease. Recently, at the age of 42 years otorhinological controls led to presentation at a cystic fibrosis (CF) centre where CF with the genotype Fdel508/3849+10 kb C→T was diagnosed despite borderline sweat tests. Atypical CF should be considered in chronic persistent rhinosinusitis even in patients with borderline sweat tests.