Sialadenoma papilliferum of the palate: case report and literature review.

Sialadenoma papilliferum (SP) is a rare tumor of salivary gland ducts which bears a strong histologic resemblance to the more common syringocystadenoma papilliferum (SCAP). We report a case occurring on the palate of a 50-year-old man, and review the clinical and histologic features of this tumor. Because of the histologic similarities between these two tumors and squamous papillomas, polymerase chain reaction (PCR) for human papilloma virus (HPV) DNA was performed on this tumor and on two cases of SCAP, with negative results. To our knowledge, this is the first case report of SP in the dermatopathology literature.

Diagnosis of clinically unsuspected gallbladder rupture by peritoneal fluid cytology. A case report.

BACKGROUND: Rupture of the biliary system resulting in bile ascites may occur spontaneously or as a complication of inflammatory disease, biliary tract manipulation or trauma. Leakage of bile into the peritoneal cavity can cause severe chemical peritonitis, requiring rapid surgical intervention. CASE: A 64-year-old male status post total laryngectomy for squamous cell carcinoma developed abdominal pain and ascites. Diagnostic paracentesis was performed, and bile pigment was noted on cytologic examination, raising the possibility of biliary rupture. This was confirmed radiographically, and the patient underwent exploratory laparotomy, where a ruptured gallbladder was found and cholecystectomy performed. CONCLUSION: Recognition of bile pigment on cytologic examination of ascitic fluid followed by measurement of ascitic fluid bilirubin levels can alert clinicians to the presence of clinically unsuspected bile peritonitis in patients with rupture of the biliary system.