ABSTRACT
Metastatic tumors in the nose and paranasal sinuses are rare. In the present paper, a 68 year old man with metastatic renal cell carcinoma to the left frontoethmoidal region 4 years after initial nephrectomy is presented Pathologic diagnosis of the case was Clear Cell Carcinoma. The patient complained of mild nasal obstruction and intermittent epistaxis, but the significant symptom was bulging in medial canthus from 20 days before. Clinical and endoscopic examinations of the left nasal cavity revealed a vascular mass in the axillary of the middle turbinate and anterior ethmoidal sinuses extending to the left orbital cavity
The patient was treated with partial endoscopic sinus resection and chemoradiotherapy. He had a complete clinical response without any significant complications and recurrence of the tumor after 6 months follow up using interanasal endoscopic examination
ABSTRACT
Despite presence of a body of evidence in support of high accuracy of cholecystokinin cholescintigraphy [CCK-CS], for diagnosis of chronic cholecystitis[CC], some authors have claimed that gallbladder ejection fraction [GBEF] has poor predictive diagnostic values. The purpose of this study was to determine if there is any difference in GBEF between normal individuals and patients with CC. In a prospective case-control study, we studied 36 subjects as control group who did not have any abdominal symptoms, or history of abdominal disease or gallstone. Patients group were 42 with established choronic calcalous cholecystitis[CCC] who complaining of chronic biliary-like pain and had gallstone on ultrasonography. All subjects underwent gallbladder scintigraphy and GBEF was calculated at 30 and 60 minutes after fatty meal [FM] ingestion. In control group GBEF at 30-minute and at 60-minute after FM ingestion were 69.54% +/- 21.04% and 84.26% +/- 11.41% respectively while in patients group GBEF at 30-minute was 61.21% +/- 16.01% and at 60-minute was 80.22% +/- 12.57%. No significant difference was noticed between control and patient groups. GBEF didn't show significant difference between different groups based on the number of gallbladder stone, severity of chronic inflammatory [lymphoplasma] cell infiltration, wall thickness and evidence of fibrosis in the gallbladder wall. Our data are against the diagnostic value of the GBEF as measured by FM-CS in the workup of patients with CC. Thus, interpretation of GBEF should take the proper clinical context into consideration
ABSTRACT
Hodgkin's lymphoma is a malignant neoplasm of B lymphocytes and less common T lymphocytes that morphologically can be mistaken with several benign and malignant diseases. These diseases have different course, treatments and prognosis from Hodgkin's lymphoma. Immunohistochemical staining is very useful that will aid in separating Hodgkin's Lymphoma from a series of benign and malignant lookalikes. We Randomly selected 53 cases with primary diagnosis of Hodgkin's lymphoma in pathology laboratory of Imam Reza Hospital from 1374-1384. to confirm or rule out of the primary diagnosis, microscopic evaluation and Immunohistochemical staining were done. Overall in 47 cases [88.7%], Hodgkin's lymphoma was confirmed and 6 cases [11.3%] were non hodgkin lymphoma.A total 5 cases were T cell Rich large B cell lymphoma and 1 case was anaplasic large cell lymphoma probably. In Hodgkin's lymphoma cases, the mean age was 40 years. Except for nodular sclerosis other types were more frequent in males. [M/F = 2.5].The commonest type was mixed cellularity [39 cases] [54.7%]. Misdiagnosis of Hodgkin's lymphoma without Immunohistochemical staining was 11.3%. Because of significant difference between treatment and prognosis of Hodgkin's lymphoma and other morphologically similar diseases, immunohistochemical staining particulary in lymphocytic depletion and nodular lymphocytic predominant Hodgkin's lymphoma, is necessary and recommended
Subject(s)
Humans , Male , Female , Immunohistochemistry , Lymphoma, Non-HodgkinABSTRACT
There is no single test as a gold standard for the diagnosis of allergic rhinitis [AR]. This study was to assess the usefulness and validity of nasal smear as a quick, easy and inexpensive diagnostic method for diagnosis of allergic rhinitis. This study was conducted in a university hospital setting. Nasal smears were taken from 39 patients with a clinical history of nasal allergy and a positive skin prick test to at least one aeroallergen as well as 26 controls without any history and negative test. Biopsy specimens from the inferior turbinate as well as nasal smears of 19 cases including 9 patients and 10 controls with the same criteria were taken. Nasal smears and biopsy slides were stained with Giemsa and Hematoxilin-Eosin and were examined blindly by two separate pathologists. Fifty one percents of the patients and 11.5% of the controls showed eosinophilia in their nasal smear [>/=10% eosinophils, P=0.001]. The sensitivity of nasal eosinophil count as a diagnostic test for AR was 51.3% with a specificity of 88.5%, a positive predictive value of 87% and a negative predictive value of 54%. Eosinophilia in nasal biopsies was found in 44% and 30% of allergic patients and controls respectively. There was no significant correlation between symptoms or positive skin tests with either smear eosinophilia or tissue eosinophilia. Evaluation of eosinophils in nasal smear is an insensitive but fairly specific test for the diagnosis of allergic rhinitis. It seems that the nasal secretions and nasal tissue represent two distinct cellular compartments