Tornwaldt's bursa.

Tornwaldt's bursa results from the embryological relationship of the notochord to the developing foregut. Its embryology and anatomical location is separate from Rathke's pouch which is the primordial anterior hypophysis. Trauma and subsequent inflammation of the defect leads to a complex of symptoms known as 'Tornwaldt's disease' which may be quite confusing to the clinician. Appropriate therapy which includes excision or marsupialization of the cyst will provide complete relief of the symptoms. The embryology, anatomy and therapy of this entity are discussed in detail. Other abnormalities which may mimic Tornwaldt's disease are described along with an embryological and histological differentiation.

Retropharyngeal pseudomasses.

The false impression of a retropharyngeal mass on lateral radiographs of the neck is not uncommon, particularly in the pediatric patient. With careful attention to radiographic technique, positioning of the patient, and the proper timing with regard to respiration, the diagnosis of a "pseudomass" can be avoided.

Hurthle cell tumors of the thyroid gland.

Hurthle cell lesions of the thyroid gland, which are derived from follicular cells, occur in a variety of thyroid diseases. Hurthle cell neoplasms are generally easy to differentiate from non-neoplastic lesions, but the separation of benign from malignant Hurthle cell tumors is difficult on a purely histologic basis unless capsular or vascular invasion or metastases are present. Since this distinction is so difficult to make, the authors recommend treating all Hurthle cell neoplasms as potentially malignant. Treatment includes total thyroidectomy, peritracheal node dissection and if palpable jugular nodes are present, a regional node dissection. A series of 11 patients with this disease and the literature are reviewed to document these recommendations.

Lateral sinus thrombosis.

The incidence of lateral sinus thrombophlebitis has been significantly reduced since the advent of antibiotics. This entity is rarely encountered in clinical practice, so a high index of suspicion is essential for early diagnosis and appropriate management. Although uncomplicated dural venous thrombosis carries an excellent prognosis with proper treatment, delay in diagnosis and institution of appropriate therapy may lead to serious, or even fatal, consequences. It is hoped that this case report and discussion will serve to increase the awareness of lateral sinus thrombophlebitis as a potential complication of suppurative otitis media.

Esophageal stenosis due to cartilaginous tracheobronchial remnants.

In cases of congenital esophageal stenosis, tracheobronchial remnants in the distal esophagus should be considered a possible diagnosis. The cause is thought to be esophageal sequestration of a tracheobronchial anlage before embryologic separation. Primary resection of the stenotic portion of the esophagus with re-anastomosis is recommended. Such a case is reported.

Cutaneous histoplasmosis.

Cutaneous lesions as a manifestation of histoplasmosis, primarily a disease of the respiratory system, are rare and most commonly appear secondary to progressive dissemination. A patient with documented progressive, disseminated histoplasmosis, having been treated previously with amphotericin B, presented on a second occasion with cutaneous lesions as the chief complaint. Biopsy and cultures of these lesions were positive for Histoplasma capsulatum. A review of the English literature revealed only 7 reported cases of secondary skin histoplasmosis in the past 20 years. All patients, including the current one, either had diseases associated with depressed immunity or were receiving steroid therapy.