Acinic cell carcinoma originating in the nasal septum.

Acinic cell carcinoma represents approximately 2.5% to 4% of all salivary gland tumors and 13% of all malignant parotid tumors. The nasal septum is a rare site of an acinic cell carcinoma. We have treated such a tumor in a 47-year old man who had been asymptomatic for the past 1.5 year. This is the second reported case of acinic cell carcinoma at the nasal septum.

Diagnostic significance of impression cytology in allergic rhinoconjunctivitis.

Impression Cytology (IC) is a noninvasive and easily repeated technique for investigating many pathologies of the conjunctiva such as dry eye, drug toxicities, and melanoma. In addition to skin tests and determination of serum IgE levels, the presence of eosinophilia in the nasal mucosa and the conjunctiva is an important diagnostic factor in allergic rhinoconjunctivitis. Eosinophilia can classically be shown by the nasal smear technique as well as IC. The nasal smear is a difficult test to carry out and does not always give adequate results. With this in mind, we collected cells from the nasal mucosa and superior palpebral conjunctiva from 27 patients with allergic rhinoconjunctivitis (17 female, 10 male) using 5 x 5 mm, 0.22 micron pore-sized cellulose acetate paper. The specimens were fixed in 95% alcohol and were then stained with hematoxylin eosin and periodic acid-Schiff stain for examination by light microscopy. Taking the free and intraepithelial eosinophilia into consideration, the specimens were grouped. Of all patients, 92.6% and 85.2% had nasal and conjunctival eosinophilia, whereas 44.4% and 25.9% had nasal and conjunctival mononuclear cells, respectively. Our study has shown that IC is a very reliable and practical technique that offers a valuable alternative test for investigating both the intraepithelial and free eosinophilia in allergic rhinoconjunctivitis and other pathologies that cause cytologic changes.

Lead article: The prognostic significance of proliferating cell nuclear antigen (pcna) in laryngeal cancer.

Squamous cell carcinoma arising from upper aerodigestive tract carries with it a significant morbidity and mortality and, over the last few decades, its incidence has steadily increased. The management of patients requires thorough investigation to determine the local, regional, and distant extent of the disease, and treatment options include surgery, radiotherapy, chemotherapy, or combinations of these.Despite the large number of therapeutic and hsitopathologic studies in print, there is currently no morphologic or cytologic feature available which consistenly predicts outcome in patients with laryngeal carcinoma. The use of proliferating cell nuclear antigen (PCNA), a newly available marker of a cell's proliferative activity ( S-phase fraction), was evaluated in 25 cases of squamous cell carcinoma of the larynx. PCNA scores differed, statistically significantly as far as the localization of the lesion, pathological grade, clinical stage, presence of lymph node metastases and prognosis of the patients were concerned.These data suggest that PCNA is an indicator of the malignant potential of the larynx. PCNA can be used in decision making for treatment and assessing prognosis in carcinoma of the larynx.

Giant cholesteatoma of the external auditory canal.

Cholesteatomas are found almost exclusively in the middle ear and mastoid. Occasionally this disease is seen in the external auditory canal. Cholesteatoma of the external auditory canal is a rare condition. Severe pain and profuse discharge associated with a normal eardrum and normal hearing are essential clinical features. In addition, we found facial paresis and conductive hearing loss in our case. Smaller cholesteatomas can be managed by frequent debridement in the office; larger lesions require surgical intervention. Surgery is successful in resolving otorrhea and relieving pain. In addition, our own experience has shown that surgery is successful in relieving facial paresis.