ABSTRACT
We report the case of a diffuse tenosynovial giant cell tumour to be found adjacent to the thyroid gland. These tumours, also known as extra-articular pigmented villonodular synovitis, are found more commonly in the fingers, wrist, knee thigh and foot, rarely in the head and neck. These tumours are prone to local recurrence, require a high clinical index of suspicion and if they have atypical features may be extremely difficult to obtain a histological diagnosis.
Subject(s)
Giant Cell Tumors/diagnosis , Head and Neck Neoplasms/diagnosis , Synovitis, Pigmented Villonodular/diagnosis , Biopsy , Female , Giant Cell Tumors/surgery , Goiter/surgery , Head and Neck Neoplasms/surgery , Humans , Immunohistochemistry , Magnetic Resonance Imaging , Middle Aged , Synovitis, Pigmented Villonodular/surgery , Thyroid GlandABSTRACT
We aim to develop a rapid, accurate and sensitive diagnostic assay with which to detect the surface antigens of fungi thought to be involved in allergic fungal rhinosinusitis (AFRS), by assessing the usefulness of immunofluorescence microscopy (IMF) and enzyme linked immuno-absorbent assays (ELISA). The age, sex, clinical symptoms and signs, imaging (CT and/or MRI), microbiological subculture data, sinus contents, blood eosinophilia, aspergillosis precipitins, radioallergoabsorbent technology (RAST) for fungal allergens and histopathology were performed on individuals undergoing endoscopic sinus surgery for suspected AFRS. Thirteen patients were examined, and five monoclonal antibodies raised to the surface washings of various fungi were found to recognize and differentiate between fungal species implicated in sinus disease, i.e. Aspergillus niger, Alternaria alternata, Cochliobolus lunata, Penicillium expansum and Cladosporium species. The IMF microscopy proved to be a useful assay to distinguish visually between the cultured fungi, but was less useful for visualization of fungi in the patient samples. However, ELISA assays with 5 monoclonal antibodies gave clear and unambiguous data as to the presence of certain fungi within the patient samples. There is good correlation between the ELISA data and the pathology findings. This preliminary study suggests that both IMF and ELISA techniques may offer an important advance in this area.
Subject(s)
Antigens, Fungal/analysis , Mycoses/diagnosis , Rhinitis, Allergic, Perennial/diagnosis , Sinusitis/diagnosis , Adolescent , Adult , Aged , Diagnosis, Differential , Enzyme-Linked Immunosorbent Assay , Female , Humans , Male , Microscopy, Fluorescence , Middle Aged , Mycoses/pathology , Paranasal Sinuses/immunology , Paranasal Sinuses/pathology , Predictive Value of Tests , Radioallergosorbent Test , Rhinitis, Allergic, Perennial/immunology , Rhinitis, Allergic, Perennial/pathology , Sinusitis/immunology , Sinusitis/pathologyABSTRACT
The procedure currently used to diagnose infection in otitis externa has several limitations: it is slow to culture organisms on growth media, fungal infections are often missed, and extensive laboratory facilities and mycological expertise are required. A rapid, accurate and sensitive assay would greatly improve patient care by initiating appropriate antifungal treatment at the onset of disease. We report the development of a rapid detection assay for otomycosis using fungal-specific monoclonal antibodies to detect fungi in ear swabs by immunofluorescence microscopy. This assay could form the basis of a detection assay for fungal infections of the head and neck.
Subject(s)
Mycoses/diagnosis , Otitis Externa/microbiology , Adult , Antibodies, Monoclonal , Enzyme-Linked Immunosorbent Assay , Female , Humans , Male , Microscopy, Fluorescence , Specimen HandlingABSTRACT
The aetiology and microbial flora of nasal polyps is not well understood. No study in the literature has reported an association between the sub-bacterium Mycoplasma pneumoniae and nasal polyps. We have developed an assay method using the Polymerase Chain Reaction (PCR) to amplify a specific region of the M. pneumoniae DNA in extracts of clinical samples using species-specific primers designed to a region of the 16S rRNA. The presence of M. pneumoniae was detected in 13/14 (93%) nasal polyps, in 4/5 (80%) rhinosinusitis mucosal samples but only in 1/7 (14%) of control samples (obstructive turbinates). An epidemic of infections due to M. pneumoniae is expected to occur in 1995. We believe this assay could form the basis of a rapid technique for M. pneumoniae detection. We also propose that the presence of M. pneumoniae may be of importance in the aetiology of nasal polyps.
Subject(s)
Mycoplasma pneumoniae/isolation & purification , Nasal Polyps/microbiology , Sinusitis/microbiology , Blotting, Southern , DNA Primers , Electrophoresis, Agar Gel , Gene Amplification , Humans , Nucleic Acid Hybridization , Polymerase Chain ReactionABSTRACT
This study considers the effect of the removal of a ventilation tube from the tympanic membrane of an ear which has been affected with persistent mucopurulent discharge for at least 3 months. The records of 332 patients were reviewed. Thirty-three patients with 34 ears satisfied the entry criteria. Tube removal cured 27 out of 34 ears (79%) of aural discharge within 1 month. The tympanic membrane healing rates were: at 1 month, 14 (41%); at 3 months, 23 (68%); at 6 months, 24 (71%); and at 1 year, 28 (82%). A table is presented comparing perforation rates from different ventilation tube studies.
