A 31 years old Chinese male with acquired immunodeficiency syndrome (AIDS) presented with concurrent mycobacterial infection and a synchronous non-Hodgkin's lymphoma of the nose. The diagnoses were made over a period of two months. Treatment for the mycobacterial infection was administered but he succumbed to the disease shortly after the diagnosis of NHL was established. This was an unusual case where two pathologies occurred in the same site in a patient with AIDS.
Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy (SHML), is a systemic disease involving nodal and extranodal tissues. We report a 48-year-old female with recurrent nasal obstruction due to polypoidal masses involving the nasal sinuses, turbinates and septum bilaterally, and lumps in the right infra-orbital region and region of the right lacrimal sac. A 4 cm right upper neck mass was also noted, which was initially diagnosed as histiocytic lymphoma. Histopathology of the nasal and infraorbital lesions revealed fibro-inflammatory masses containing histiocytic cells with large vesicular nuclei and abundant foamy cytoplasm exhibiting emperipolesis and lymphophagocytosis, admixed with scattered plasma cells and lymphocytes. These histiocytes revealed immunohistochemical positivity for S-100 protein and CD68, but were negative for CDla. The findings supported a diagnosis of RDD. This report serves to remind pathologists and clinicians of the extranodal manifestations of RDD and its potential confusion with lymphomas.
Carcinoma of the tongue remain one of the greatest management challenges for the head and neck surgeon because of the adverse effects of treatment on oral and pharyngeal function. In early carcinoma of the base of tongue however, the prognosis is encouraging and function of swallowing and speech is preserved despite surgery. Suprahyoid pharyngotomy is one of the surgical approaches advocated for resection of base of tongue tumours with primary anastomosis.
Recurrent facial baroparesis is a rare condition that is mostly observed in individuals who have been exposed to barotraumatic conditions, particularly scuba divers and air travelers. We present a case of an unusual bilateral alternating recurrent facial nerve palsy and its successful treatment. A 34-year-old airline stewardess presented with a seven-month history of recurrent bilateral alternating facial nerve palsy that occurred exclusively during airline takeoffs. A clinical diagnosis of facial baroparesis was made. The temporal bone's high-resolution CT (HRCT) scan revealed a bilateral tympanic segment of the facial canal wall dehiscence. Conservative treatment with oral antihistamines and nasal decongestants proved ineffective in treating this unusual condition. The patient then underwent bilateral Eustachian tube dilatation as well as bilateral myringotomy and grommet insertion. Post-treatment, she became asymptomatic despite multiple re-exposure to high-altitude travel. With our successful reported case of this uncommon recurrent condition, Eustachian tube dilatation as well as myringotomy and grommet insertion could potentially become the standard approach to treatment.
Heterotopic neuroglial tissue is a rare congenital lesion with predilection in head and neck region. We report a case of a newborn who presented with an oral cavity mass with intracranial extension and later respiratory distress that was successfully excised via transcranial and transcervical approach.