A case of bilateral eosinophilic granuloma in the temporal bone

We present a case of bilateral eosinophilic granuloma in the temporal bone in a 47-year-old woman, who visited our hospital with a headache and a feeling of occlusion in her left ear. Her left tympanic membrane was slightly turbid and pure tone audiometry revealed mild left sensorineural deafness. CT disclosed a shadow of soft tissue in the left mastoid antrum and mastoid cells, which was indicative of marked destruction of the bone. Because MRI findings led us to suspect otitis media cholesteatoma, a mastoidectomy was performed. The mastoid antrum and mastoid cells were filled with easily bleeding granulation, and there was a wide range of bone deficit in the posterior cranial fossa. Histopathologically, the granulation tissue was an eosinophilic granuloma. Her postoperative clinical progress was good and she was discharged. However 2 months after discharge, she had a feeling of occlusion in the right ear and CT revealed a shadow in the right mastoid antrum and cells. Therefore, right tympanoplasty was performed and the same findings as in the left ear were obtained. A histopathological diagnosis of eosinophilic granuloma was made again. To date, there has been no recurrence.

[Pathological evaluation of superselective one-shot intra-arterial infusion chemotherapy for head and neck tumors]

Since 1992, we have treated 43 patients with head and neck tumors by superselective intra-arterial infusion chemotherapy (SIIC) via femoral artery. In 8 patients among then, operation was performed thereafter with/without radiation therapy (RT). CDDP and/or CBDCA were utilized as the chemotherapeutic modality. Only SIIC or RT showed Grade (Gr.) 0-2b pathological effects on Oboshi-Shimosato classification scheme, while a combination of SIIC and RT exhibited Gr. 2b-4 pathological effects. We conclude that a combination of SIIC and RT was most effective and had induced degeneration or necrotic changes in the tumor tissue.

[A case report of adenoid cystic carcinoma of the nasal septum]

A 50-year-old woman with adenoid cystic carcinoma of the nasal septum is presented. Her chief complaint was recurrent epistaxis. Surgery was originally performed to remove a nasal polyp, but during resection, the surgeon discovered that the mass had arisen from the nasal septum, so only a biopsy was done. The pathological report was adenoid cystic carcinoma, so she was referred and admitted to our hospital. A flat 1.5 x 1.5 cm tumor was recognized on the left side of the nasal septum. Nasal septectomy was performed. The tumor was dissected with nasal septal cartilage, and the defect was covered with a free skin flap from the thigh. The incidence of malignant tumors from the nasal septum is very low, composing from 2.7% to 8.4% of nasal and paranasal malignant tumors. Therefore the incidence of adenoid cystic carcinoma in particular is very low.

Immunohistopathological properties of pleomorphic adenoma in salivary gland

Fifty-eight salivary gland pleomorphic adenomas and 5 normal salivary glands were studied immunohistochemically with respect to intermediate filaments (keratin, desmin, and vimentin), actin and S-100 protein to observe the cellular differentiation of these tumor cells. Normal myoepithelial cells showed positive immunostaining for actin, vimentin and S-100 protein. Pleomorphic adenomas expressed keratin, vimentin and S-100 protein to various degrees, but only a few tumor cells of pleomorphic adenoma revealed actin. The results indicate that the tumor cells of pleomorphic adenoma show a bipolar differentiation capability of both epithelial and mesenchymal origins, although normal myoepithelial cells show only mesenchymal characteristics. The findings also support previous reports using light and electron microscopy, and also contribute to more precise diagnosis and a better understanding of the histogenesis of this tumor.