Recurrent respiratory papillomatosis in northern Sweden: Clinical characteristics and practical guidance

Conclusion: Recurrent respiratory papillomatosis (RRP) patients with high surgical treatment frequency (≥ 1/year, HF) were significantly younger and had a more widespread laryngeal disease compared to a low frequency treated group (< 1 treatment/year, LF). This study confirms the existence of a clinical RRP group, not primarily related to HPV sub-type, but more care-intensive and in need of more vigilant follow-up. Objectives: RRP is associated with high morbidity due to its influence on breathing and voice. The purpose of this study was to characterize RRP patients in northern Sweden and investigate possible predictor factors affecting therapeutic needs. Method: Patients from the regional referral area (northern Sweden) were categorized for age, disease duration, juvenile or adult onset, profile of disease development, number of surgical sessions in relation to disease duration, laryngeal deposition of papilloma, gender, and HPV sub-types, in order to identify patients with increased need for frequent surgical treatment. Results: The median age of the RRP patients (n = 48) was 44.5 years; 34 (71%) were males and 14 (29%) females, most were infected with HPV 6. Patients with high surgical treatment frequency/year were significantly younger and showed more widespread papillomatous vegetation in the larynx, compared to the low frequency treated group.     

Intravenous cidofovir treatment for recalcitrant warts in the setting of a patient with myelodysplastic syndrome

Cidofovir is an acyclic nucleoside phosphonate with broad-spectrum activity against DNA viruses, including human papilloma virus (HPV). However, data on the efficacy of cidofovir in an immunosuppressive setting remain contradictory. We report for the first time on the promotion of the healing of recalcitrant warts in a patient with myelodysplastic syndrome with intravenous cidofovir treatment.     

Spinal Drop Metastasis from a Posterior Fossa Choroid Plexus Papilloma

Choroid plexus papillomas (CPPs) are typically considered as benign tumors, with a favorable long-term prognosis. Drop metastasis of CPP into the spinal subarachnoid space is rare. We report a 42-year-old woman who presented with headache and back pain 6 years after removal of a posterior fossa CPP. Magnetic resonance imaging revealed mass lesions in the lumbosacral subarachnoid space and recurrent intracranial tumor. The lesions were resected and histologically diagnosed was CPP. We consider that CPP can spread via cerebrospinal fluid pathways and cause spinal drop metastasis. Therefore, it is necessary to evaluate the whole spinal axis and to perform periodic follow-up examinations in patients with CPP.     

鼻腔鼻窦恶性肿瘤83例报告

目的 :评价鼻腔鼻窦恶性肿瘤的治疗方法及其效果。方法 :83例原发于鼻腔、上颌窦、筛窦、蝶窦及额窦的恶性肿瘤 ,分别施行上颌骨次全与全切除术 ,前额开窗 -鼻锥翻转进路额筛蝶眶肿瘤大块切除及颅面联合切除术 ,部分病例实施冷冻切除 ,颌颈联合根治等手术 ,术后常规放疗。结果 :3年生存率为 4 7.5 %(36 76 ) ,5年生存率为 36 .2 %(2 5 6 9)。结论 :鼻腔鼻窦恶性肿瘤通过手术及采用术后放疗等综合治疗 ,可提高疗效 ,但仍需进一步改进治疗方法 ,以提高患者生存率。     

Bilateral choanal atresia and paranasal sinus hypoplasia in an adult patient with hypogammaglobulinaemia

We present an unusual case of a young female patient presenting with bilateral choanal atresia, which was probably acquired, associated with nasal and paranasal sinus hypoplasia and hypogammaglobulinaemia.     

Endoscopic and Histologic Findings of Intraductal Lesions Presenting with Nipple Discharge

Abstract:   To improve the utility of mammary ductoscopy, we investigated the correlation between endoscopic findings and histologic findings using intraductal biopsy specimens. Seventy-one intraductal biopsy specimens obtained from 63 patients between October 2001 and March 2004 were analyzed retrospectively. All specimens were obtained from monotonous intraductal lesions immediately after observation by mammary ductoscopy and were composed of a pure histologic subtype. With regard to endoscopic findings, color was classified as yellow, red, white, or colorless, and morphology was classified as spherical, lobular, mulberry, or amorphous. The histologic subtype was classified as papillotubular, papillary, degenerated, papillary cancer, solid-type ductal carcinoma in situ (DCIS), or cribriform cancer. The relationship between histologic diagnosis, color, and morphology was investigated. Intraductal biopsy specimens included 25 specimens of carcinoma and 46 specimens of papilloma. There was no significant correlation between color and diagnosis. Fourteen of 25 carcinoma specimens were amorphous, and amorphous morphology was significantly suggestive of malignancy (p < 0.001). Further, cribriform cancer was associated with amorphous morphology and yellow color. Morphology may be a useful endoscopically delineated parameter for differentiating intraductal lesions.      

Morphometric study of nucleolar organizer regions in human oral normal mucosa, papilloma and squamous cell carcinoma

A morphometric study of nucleolar organizer regions (NOR) was performed to analyze their distribution, volume, number and shape in the different strata of human normal oral mucosa epithelium and papilloma and in squamous cell carcinoma employing microphotographs of silver-stained paraffin sections. The different NOR-related parameters evidenced significant differences between normal mucosa, papilloma and squamous cell carcinoma. The functional polarity of normal mucosa epithelium and of papilloma is also evidenced in terms of NOR-related parameters. The discriminative value of certain NOR parameters was demonstrated.     

聚合酶链反应检测尖锐湿疣皮损内人乳头瘤病毒

１３个皮损组织取自１３例尖锐湿疣（ＣＡ）患者，１３例基底细胞上皮瘤（ＢＣＣ）组织作为对照，用溴化钠液分离表真皮，从组织中提出的 ＤＮＡ和溴化钠液分别用聚合酶链反应检测 ＨＰＶ ＤＮＡ。１１例ＣＡ表皮中检出 ＨＰＶ ＤＮＡ，ＨＰＶ６有７例，ＨＰＶ１１有４例。３例ＣＡ真皮中发现有ＨＰＶ ＤＮＡ，ＨＰＶ６有２例，ＨＰＶ１１有１例。２例标本因溴化钠液被ＨＰＶ污染未作统计。在ＢＣＣ组织中未发现有ＨＰＶ ＤＮＡ。在某些ＣＡ真皮内含有 ＨＰＶ ＤＮＡ可以解释散发病例的复发性。     

18例原发鼻腔和鼻窦的T/NK淋巴瘤的临床分析

目的：探讨原发于鼻腔和鼻窦的T／NK恶性淋巴瘤的临床特点。方法：对18例患者的临床资料进行回顾性分析。结果：鼻腔和鼻窦的T／NK淋巴瘤首发症状不典型，多为鼻塞、涕血、局部肿胀及发热等，临床误诊率高；高分期及高侵袭性淋巴瘤预后差。结论：鼻腔鼻窦的T／NK淋巴瘤是结外非霍奇金恶性淋巴瘤(NHL)的一个独特类型，首发症状多样，临床上应注意对该病的认识，防止误诊；预后有赖于病理分型和临床分期。