Biomedical subjects
Publications and source records attributed to D K Heffner.
Vascular tumors and lesions of the nasal passages of children can be easily misdiagnosed. The clinical and histopathologic features that aid differential diagnosis are discussed.
The terminology, classification, and histopathologic features of teratoid and neural masses of the nasal area of children can be confusing. Definitions, clinical features, and histopathologic differential diagnoses are discussed.
The clinical and histopathologic diagnostic problems of childhood nasopharyngeal carcinoma, sinonasal epithelial tumors, and Burkitt's lymphoma are described, and the relationship of the Epstein-Barr virus to tumors is discussed.
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The pathologic features and the behavior of 50 cases of adenocarcinoma (excluding adenoid cystic carcinoma and mucoepidermoid carcinoma) of the sinonasal tract are presented. The cases were divided on histologic grounds into 23 low-grade and 27 high-grade neoplasms. The low grade lesions had a well developed glandular pattern throughout, very uniform nuclei, and minimal mitotic activity. The high grade tumors had a less uniform glandular pattern, commonly with solid or sheet-like areas, manifested nuclear pleomorphism, and generally had a higher mitotic rate. The low-grade group had a prognosis markedly better than the high-grade group. Since the literature tends to consider all sinonasal adenocarcinomas as relentlessly progressive neoplasms with poor prognosis, it is important to recognize this category of low grade neoplasm in order that treatment and prognostication can be better related to their behavior.
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A case of Torulopsis glabrata endocarditis involving the mitral valve is reported. Endocarditis developed during convalescence from severe abdominal trauma and was associated with fungemia. Morphologically characteristic organisms were present in the mitral valve.
INTRODUCTION: This study reviews the clinicopathologic features of carcinoma presenting in oncocytic Schneiderian papilloma (OSP; cylindrical cell papilloma), a rare histologically distinctive papilloma sharing features with inverted papilloma. MATERIALS AND METHODS: Nine cases of carcinoma ex OSP (1970-1990), six from the files of the Armed Forces Institute of Pathology (Washington, DC) and three from the surgical pathology files, Presbyterian-University Hospital and Eye and Ear Institute (Pittsburgh, PA), were studied. One case was previously reported. Clinical data were obtained from the patients' medical records. All available histologic slides were reviewed. RESULTS: The patients (eight men, one woman) ranged in age from 48 to 83 years (mean age, 74 years). The carcinoma and OSP were synchronous in eight patients. In one case, the carcinoma occurred 8 years after OSP was diagnosed on biopsy. The presenting manifestations included nasal obstruction, "polyps," epistaxis, and proptosis. Radiographically, a sinonasal mass was present, often with extension to adjacent sites and bone destruction. Most patients received postoperative irradiation. Of six patients with follow-up, four died of carcinoma and two were alive without disease at 1.5 and 7 years, respectively. The types of carcinoma were: squamous cell (n = 6), high-grade mucoepidermoid (n = 2), and sinonasal undifferentiated (n = 1). Histologic transition was observed between carcinoma and dysplastic/benign OSP in eight cases. CONCLUSION: Demonstration of histologic continuity between carcinoma and dysplastic OSP epithelium in eight of our nine cases indicates origin of carcinoma from the OSP, rather than a coincidence of the two neoplasms. Although histologically benign, OSP should be totally excised at diagnosis because of a potential for malignant transformation. This is a US government work. There are no restrictions on its use.