RESUMO
Squamous cell carcinoma of the middle ear (SCCME) accounts for 1.5% of malignant tumors in the ear. Because of the low incidence and infrequent reports of SCCME, the extent of concordance between CT and MRI results, surgical findings, and pathology reports are not well-characterized. In the present study, we reported CT and MRI images in three SCCME cases, and assessed the relationship between these results and those of surgery and the pathological report. Middle ear carcinoma is frequently misdiagnosed before surgery. In three cases of middle ear carcinoma, CT revealed the following: 1) soft tissue density lesions centered around the middle tympanum, exhibiting increased density, with external auditory canal involvement; 2) damage and absorption in the mastoid area, ossicles, and facial nerve canal, characterized by an irregular, worm-eaten appearance, without sclerotic margins; and 3) lesion infiltration of the surrounding bony substance of the middle ear, temporal squama, temporomandibular joint, anterior wall of the sigmoid sinus, and horizontal segment of the canalis caroticus (in one case lesion invasion into the intracranial cavity occurred through sigmoid sinus walls; no signs of intracranial invasion were seen in the other two cases). Enhanced lesion imaging revealed partial heterogeneous enhancement. In one patient MRI revealed a defined mass in the mastoid area of the middle ear. Signals in the lesion were partially heterogeneous and similar to brain tissue in T1- and T2-weighted images. The lesion was significantly enhanced following application of a contrast agent, while the adjacent meninges also exhibited linear enhancement. No abnormal signals were detected in the brain parenchyma. The destruction of adjacent bone plates was poorly defined. The CT and MRI results were consistent with the invasive features of middle ear cancer documented in the post-surgery pathology report.
RESUMO
OBJECTIVE: To investigate the expression of interleukin (IL) 17A in Chinese patients with chronic rhinosinusitis (CRS) and analyse its correlation with clinical parameters. METHODS: Patients undergoing functional endoscopic sinus surgery and matched controls were included in this retrospective study. Clinical assessments (using a visual analogue scale of symptom severity, Johansson endoscopic score and Lund-Mackay computed tomography score) were performed preoperatively. Mucosal specimens were analysed for inflammatory infiltration and IL-17A expression, using immunohistochemistry. RESULTS: In total, 40 patients undergoing functional endoscopic sinus surgery and 16 controls were included in the study. IL-17A levels were significantly higher in tissues from patients with CRS (with or without nasal polyps) than in control tissues. In CRS, IL-17A expression tended to be higher in tissues with infiltrating neutrophils than in those with infiltrating eosinophils, but this difference was not significant. IL-17A expression in CRS was positively correlated with symptom severity, endoscopic findings and radiological appearance. CONCLUSIONS: Expression of IL-17A was higher in Chinese patients with CRS than in controls, and was associated with infiltrating inflammatory cells, symptom severity, endoscopic findings and radiological appearance. These findings suggest that IL-17A may play a role in CRS pathogenesis and remodelling of nasal polyps.
