scholarly journals Plasma cell tumors of the head and neck. Analysis of diagnostic difficulties based on literature and own data

2021 ◽  
Vol 16 (3) ◽  
pp. 50-57
Author(s):  
F. Sh. Kamolova ◽  
L. Yu. Grivtsova ◽  
S. M. Samborskiy ◽  
V. B. Larionova ◽  
Yu. E. Ryabukhina ◽  
...  

Background. Extramedullary plasmacytoma (EP) of soft tissues, which in most cases affects the organs of the head and neck region, is a relatively rare malignant tumor. Until now, there are no consensus approaches to the diagnosis and treatment of EP. Differentiating EP from other types of non-Hodgkin’s lymphomas is difficult. There are difficulties in the differential diagnosis of EP and carcinomas in the head and neck region. Given the rare occurrence of this nosological form, the frequency of diagnostic errors is quite high, which dictates the need for a thorough description of each head and neck EP case.Objective of the study: analysis of possible difficulties and reasons for incorrect interpretation of diagnostic data, and treatment for head and neck EP.Materials and methods. Clinical and morphoimmunological data of 97 primary patients with B-cell non-Hodgkin’s lymphomas (B-NHLs) of the head-neck region were analyzed.Results. In our cohort we identified 2 tumor cases of a plasma cell nature, which amounted to 2 % among all B-NHLs. In one case, the process was located in the nasal cavity and clinically manifested itself with nosebleeds. The second case is a lesion of the mouth floor, primarily with the ulcer formation. In the first cases, at diagnosis, the immunohistochemistry (IHC) test was performed after patient’s chemotherapy and radiation treatment, which distorted the tumor immunophenotype. In the second cases with extensive process in maxillary sinuses, a complete and very detailed IHC test was carried out; however the data did not allow for a definitive diagnosis. Difficulties apparently arose in the interpretation of CD38 expression – main marker of plasmacytic line cells, as well as due to the unusual morphology.Conclusion. The described diagnostic situations dictate the need for a comprehensive algorithm in the diagnosis of head and neck tumors. It is advisable to perform an extended morpho-immunophenotypic study of the tumor (IHC, immunocytology, flow cytometry, etc.), if a tumor of a plasma cell nature is suspected, a morpho-immunological study of the bone marrow is indicated.

2005 ◽  
Vol 119 (6) ◽  
pp. 492-494 ◽  
Author(s):  
J P Hughes ◽  
Silvana Di Palma ◽  
J Rowe-Jones

A literature review reveals that gout has been described as affecting many sites in the head and neck region, both in the arthritic and tophaceous form. Gout can often mimic malignancy or infection, and has been described as causing acute airway problems requiring emergency tracheotomy. Here we describe the first published case of tophaceous gout affecting the soft tissues overlying the nasal bones. The patient presented with a bony, hard, dorsal hump and requested aesthetic rhinoplasty.We also describe an endoscopic technique for removal of tophi using a powered microdebrider system with a protected burr head. Endoscopic powered microdebrider blade excision of tophi affecting the limbs has already been described, with reduced complications when compared with conventional curettage and debridement techniques. This is the first such application to the nose.


2016 ◽  
Vol 6 (12) ◽  
pp. 985-989
Author(s):  
R Pathak ◽  
KBR Prasad ◽  
SK Rauniyar ◽  
S Pudasaini ◽  
K Pande ◽  
...  

Background: Fine needle aspiration cytology is a minimally invasive technique used in the initial diagnosis of different types of lesions located in head and neck region commonly originating from cervical lymph node, thyroid gland, salivary glands and soft tissues. The objective of this study was to evaluate the diagnostic accuracy, sensitivity and speci city of FNAC in various head and neck lesions in correlation with their histopathological examination. Materials and methods: A hospital based prospective study was conducted among 209 patients with palpable head and neck region swellings in the Department of Pathology, Bhaktapur Cancer Hospital and the Department of Pathology, Nepal Medical College from August 2014 to July 2015. FNAC were done from palpable masses of head and neck regions. Data entry and analysis were done using SPSS 17. Result: There were 209 FNAC cases enrolled, out of which lymph node lesions (n=128) were the most common lesions followed by thyroid (n=40), other soft tissues (n=27) and salivary gland (n=14). Reactive lymph nodes, colloid goiter, epidermoid cyst and sialadenosis were the predominant diagnosis of lymph nodes, thyroid gland, soft tissues and salivary gland respectively. Highest accuracy, sensitivity and speci city were observed in thyroid gland, salivary gland and soft tissues. However, four false negative results for malignancy were reported in lymph node lesions. Conclusion: Head and neck region swellings are the commonly encountered conditions. FNAC being highly accurate, sensitive and speci c makes it useful and reliable procedure for screening and diagnosis of palpable masses in head and neck region. 


2011 ◽  
Vol 05 (03) ◽  
pp. 340-343 ◽  
Author(s):  
Ozkan Miloglu ◽  
Sare Sipal Altas ◽  
Mustafa Cemil Buyukkurt ◽  
Burak Erdemci ◽  
Oguzhan Altun

ABSTRACTRhabdomyosarcoma (RMS), a tumor of skeletal muscle origin, is the most common soft tissue sarcoma encountered in childhood and adolescence. The common sites of occurrence are the head and neck region, genitourinary tract, retroperitonium, and, to a lesser extent, the extremities. In the head and neck region, the most commonly affected sites are the orbit, paranasal sinuses, soft tissues of the cheek, and the neck. RMS is relatively uncommon in the oral cavity, and the involvement of the jaws is extremely rare. Here, we report a case of oral RMS in a 13-year-old child and describe the clinical, radiological, histopathological, and immunohistochemical findings. (Eur J Dent 2011;5:340-343)


2019 ◽  
Vol 10 (1) ◽  
pp. 48-53
Author(s):  
Mohammad Sowkat Hossain ◽  
S M Mahbubul Alam ◽  
Sk Md Jaynul Islam ◽  
Wasim Selimul Haque ◽  
Shamoli Yasmin

Background: Undifferentiated tumours in the head and neck region are not uncommon. They can arise from different sites like in mucosa as well as in salivary glands, soft tissues or lymph nodes. Histopathological examination plays a central role in the diagnosis but difficulties arise with some tumours which are poorlydifferentiated due to their high inter- and intra-observer variability. In those cases, immunohistochemistry has greatly assisted to diagnose the tumours that cannot be accurately identified using routine histopathological procedures. The correct histopathological diagnosis is essential especially in case of malignant tumourwhere subsequent specific therapy is required. The aim of this study was to determine the role of immunohistochemistry for diagnosing undifferentiated malignancy in the head and neck region. Methods: This cross-sectional study was conducted during July 2014 to June 2015. A total of 35 Bangladeshi patient’s specimens of head and neck swelling were collected from two renowned laboratories in Dhaka city.These cases were diagnosed as undifferentiated tumour in histopathological examination.Standard protocol was followed for immunohistochemistry.Then primary immunohistochemical panel which included the markers for Epithelial CK (AE1/AE3),mesenchymal marker (Vimentin) and lymphoid marker (LCA) were used.The cases which were not resolved by primary immunohistochemistry panel, the second panel was applied for further sub classification (Desmin, Chromogranin, CK20, CEA, CD20, CD30, HMB45, NSE). Based on interpretation of immunohistochemical findings final diagnoses were made.Data analysis was performed using the Statistical Package for the Social Sciences for Windows version 22.0 (SPSS, Chicago, Illinois, USA). Results: A total of 35 undifferentiated tumorsof head-neck region were studied.The mean age was 46.3±17.6 years and male to female ratio was 4.8:1. The majority 13 (37.1%) patient had cervical lymphadenopathy, 11 (31.4%) had neck mass and 4(11.4%) had in nasal/sinonasal mass.Regarding histopathologicalcell types, round cell was 21 (60.0%), spindle cell 6 (17.1%), pleomorphic cells 6(17.1%) and epithelioid cells 2(5.7%). In initial histopathological examination, majority 25(71.4%) were undifferentiated malignant neoplasm, 8(22.8%) were metastatic undifferentiated carcinoma, 1(2.9%) was pleomorphic sarcoma and the remaining 1(2.9%) had malignant adnexal tumour. By application of immunohistochemistry, most (33, 94.3%) of the cases were resolved and the two cases remained unresolved. Among the resolved cases majority (15, 45.5%) were lymphoma, 4(12.1%) were metastatic carcinoma, 3(9.1%) were Ewing’s sarcoma and malignant melanoma were found in 3(9.1%) cases. Conclusion: This study supports that the immunohistochemical technique has a fundamental role in the investigation of undifferentiated tumour origin, to determine the correct guidance for treatment and improving the prognosis for head and neck tumour patients. Birdem Med J 2020; 10(1): 48-53


1994 ◽  
Vol 33 (05) ◽  
pp. 224-228 ◽  
Author(s):  
T. Aras ◽  
A. Aktaş ◽  
S. Kaya ◽  
C. F. Bekdik ◽  
M. T. Ercan

SummaryGlutathione labelled with 99mTc was used to study blood clearance and normal distribution in 3 healthy volunteers and in 10 patients with biopsy-proven tumors in the head and neck region. Static scintigrams were obtained at 1, 3, 6, and 24 h. ROIs over tumors and normal soft tissues were compared to obtain T/N ratios. In normal subjects blood clearance reached a plateau at 6 h; no radioactivity accumulation in the head and neck region was observed. Only the cardiac blood pool, the liver, the kidneys and the urinary bladder were evident. Excretion was via the kidneys. Malignant tumors and metastases were well visualized in 7 patients (true-positive), starting at 1 h. The mean T/N ratio was 2.69 ± 0.77. The best images were obtained at 3-6 h. 1 false-positive (granula-matous reaction), 1 false-negative (malignant epithelial tumor in the radix of tongue) and 1 true-negative (angiofibroma) results were obtained. 99mTc-GSH is a potential radiopharmaceutical for the scintigraphic visualization of head and neck tumors. Further clinical studies are warranted to show its sensitivity and accuracy.


2013 ◽  
Vol 5 (3) ◽  
pp. 157-163
Author(s):  
Kerem Öztürk ◽  
Mustafa Şahin ◽  
Raşit Midilli ◽  
Gülce Gürsan ◽  
Nazan Özsan ◽  
...  

ABSTRACT Extramedullary plasmacytoma (EMP) is a rarely seen neoplasm of plasma cells which may be locally destructive by involving submucosal soft tissues of upper respiratory tract but without systemic dissemination. It comprises less than 1% of head and neck malignities. Clinical presentation depends on tumor's effect and its involvement site. Diagnosis is made with histopathologic examination of tissue biopsy. Responses to its treatment with local radiotherapy and surgery are similar. In this article; it is intended to update our knowledge regarding EMP and remind this rarely encountered disease by presenting various cases detected in nasopharynx, tonsil, buccal mucosa, larynx, mastoid cavity and sphenoid sinus, with literature line. How to cite this article Öztürk K, Şahin M, Midilli R, Gürsan G, Özsan N, Savaş R. Extramedullary Plasmacytoma of Head and Neck Region: Report of Six Cases with Different Localizations. Int J Otorhinolaryngol Clin 2013;5(3):157-163.


Author(s):  
Andrea Masarykova ◽  
Marin Dzongov ◽  
Alexandra Hanicova ◽  
Ingrid Zavacka ◽  
Danijela Scepanovic

<p>Most patients with plasma cell neoplasia have generalized disease at diagnosis. However, some patients have a solitary extramedullary plasmacytomas (SEPs). SEPs are rare, typically solitary tumors comprising approximately 3–5% all plasma cell neoplasms. Almost 90% arise in the head and neck region, especially in the nasal cavity, sinuses, oropharynx, salivary glands and larynx. Solitary extramedullary plasmacytoma (SEP) has a predilection for the male gender and occurs most frequently in patients 50 years and older. SEP often runs an indolent clinical course with a tendency for local recurrence, and progresses to plasma cell myeloma in about 15% of patients. In this paper, we have reported the case of SEP of the naso-oropharynx in 55 years old woman who was presented with a sense of the nasal obstruction. The resection was performed and a mature plasmacytoma was demonstrated histologically. However, ENT examination and positron emission tomography/computed tomography examination with 18-fluorodeoxyglucose (18-FDG PET/CT) have shown that the patient had residual naso-oropharyngeal disease after surgery. A negative bone marrow biopsy and 18-FDG PET/CT have confirmed that it was a solitary extramedullary plasmacytoma of the head and neck region. Following the surgery, intensity modulated radiotherapy (IMRT) was administered. No relapse or progression to the multiple myeloma was recorded during the 3.5 years of follow-up. This case report, which describes a rare tumor of the naso-oropharynx, is expected to improve the recognition and referral of this condition in medical practice. </p>


Author(s):  
Samira Derakhshan ◽  
Sedigheh Rahrotaban ◽  
Samaneh Shirani ◽  
Shima Abbasi

Mesenchymal chondrosarcoma as an aggressive type of chondrosarcoma shows a characteristic biphasic histopathologic pattern. The head and neck region is included a high proportion of extra skeletal sites. Very rare examples of Mesenchymal Chondrosarcoma involving the mandible have been described. Based on fragmented or tiny specimens, the diagnosis of this lesion has been re- mained a challenge because the specimens may contain only one of the two neoplastic elements. We report a rare case of mesenchymal chondrosarcoma of the mandible in a 19 years old male with delaying in diagnosis due to massive extension of the tumor to the soft tissues.


2014 ◽  
Vol 6 (3) ◽  
pp. 10-16 ◽  
Author(s):  
Kerem Öztürk ◽  
Mustafa Şahin ◽  
Raşit Midilli ◽  
Gülce Gürsan ◽  
Nazan Özsan ◽  
...  

ABSTRACT Extramedullary plasmacytoma (EMP) is a rarely seen neoplasm of plasma cells which may be locally destructive by involving submucosal soft tissues of upper respiratory tract but without systemic dissemination. It comprises less than 1% of head and neck malignities. Clinical presentation depends on tumor's effect and its involvement site. Diagnosis is made with histopathologic examination of tissue biopsy. Responses to its treatment with local radiotherapy and surgery are similar. In this article; it is intended to update our knowledge regarding EMP and remind this rarely encountered disease by presenting various cases detected in nasopharynx, tonsil, buccal mucosa, larynx, mastoid cavity and sphenoid sinus, with literature line.


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