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Esthesioneuroblastoma: problems with diagnosis and management.

Esthesioneuroblastoma is an uncommon tumor arising from the olfactory epithelium of the nasal cavity. Since most cases present clinically with non-specific findings such as unilateral nasal obstruction and intermittent epistaxis, esthesioneuroblastoma is often mistaken for other diseases of the nasal cavity. Histological confirmation of the disease can also be difficult. The aggressive nature of esthesioneuroblastoma is evidenced by frequent local recurrences and occasional distant metastases--further complicating the management of this tumor. The otolaryngologist should possess a high index of suspicion for this rare, but devastating malignancy. Guidelines for the evaluation and treatment are presented.

Humans↗

[Fiber endoscopy of the nasopharynx: its indications].

The AA have planned a series of indications regarding the endoscopy of the nasoopharynx. Among 631 explorations done in a three-year term, normal findings were seen in 260 subjects. In the other cases several aspects of the inflammatory or neoplastic pathology could be verified. One individual showed an esthesioneuroblastoma in an early evolutive stage.

Endoscopy↗

Spontaneous olfactory neuroepithelioma in a domestic medaka (Oryzias latipes).

Tumors of the central nervous system in fish are rare, and only six cases of spontaneous olfactory neuroepithelioma have been reported. This is the seventh case, found in a medaka, Oryzias latipes. The tumor was noted near the right olfactory orifice and finally measured 1.5 mm in diameter. Histologically the tumor consisted of undifferentiated neuroblasts forming a few true rosettes. Mitosis was frequently observed. Tumor cells stained diffusely for neuron-specific enolase and sporadically for neurofilament proteins by immunohistochemical procedures. Additionally a few large tumor cells were positively stained for S-100 protein. Electron microscopy revealed that the tumor cells had extended cytoplasm in which parallel neurotubules and a few neuroendocrine granules were noted. In the perinuclear region, bundles of intermediate filaments and neuroendocrine granules were seen. Single cilia and a pair of centrioles were occasionally found, but no ciliated cells were found in this tumor. Some large tumor cells contained electron-dense intracytoplasmic inclusions which showed a crystalloid structure by high-magnification electron microscopy; however, this type of crystalloid has never been reported in neuronal tumors.

Animals↗

[X-ray findings in Askin tumors].

The plain x-ray films for diagnosis and CT images of 3 patients demonstrating the histological findings of an Askin tumour are presented.

Adolescent↗

[The value of MR tomography in tumorous diseases of the inner nose and paranasal sinuses].

In the examination of the inner nose and the paranasal sinuses, magnetic resonance imaging impresses by its excellent representation of anatomical structures, due above all to the multiplanar orientation of slices, the good possibility to differentiate soft tissue structures, and the accurate visualization of lymph nodes and vessels without contrast medium. Osseous lesions can be better assessed by computed tomography, however, magnetic resonance imaging can indirectly demonstrate bone destructions, too.

Adenocarcinoma↗

[Esthesioneuroblastoma: histogenesis and diagnosis].

Tumors of the rat induced by means of two different nitrosamines (N-nitrosopiperidine, 2,6-dimethylnitrosomorpholine) were analyzed with the light and electron microscope and by immunohistological investigation. The ultrastructural analysis showed mainly in the Flexner rosettes some clear characteristics of olfactory epithelium such as olfactory vesicles, cilia, and microtubules. With four exceptions, the immunohistologically investigated tumor cells showed no immunofluorescence after incubation with antibodies against intermediate filaments. The results resemble in all aspects the structures found in human esthesioneuroepitheliomas, so that it is reasonable to speak of an identical tumor. As the sensory cells of the normal olfactory epithelium as well as the light basal cells show a negative reaction with antibodies against intermediate filaments, too, the induced tumor is derived histogenetically from the olfactory epithelium and the light basal cell is assumed to be its stem cell.

Animals↗

Some differences in steroid receptors between meningeal and neuroepithelial tumors.

In our study we evaluated the presence of steroid hormone receptors in a large series of endocranial tumors and investigated the possible correlations between receptor presence and levels and patient's age and sex. Our data indicate that steroid receptor behavior in the neoplasias considered is quite different from that observed in endocrine-related tumors, such as breast and endometrial cancer. Moreover, in neuroepithelial tumors an interesting difference between male and female subjects has been found regarding the receptor distribution in poor differentiated neoplasias.

Adolescent↗

[A case of olfactory neuroblastoma with exuberant hyperostosis].

Olfactory neuroblastoma is a malignant, slow growing, neurogenic tumor that originates in the olfactory mucosa of the upper nasal cavity. We report a case of olfactory neuroblastoma that presented with exuberant hyperostosis of the facial bone during the course. This unusual radiological finding has been discussed with literature review.

Facial Bones↗

Ultrastructural morphometry distinguishes Burkitt's-like lymphomas from neuroendocrine neoplasms: useful criteria applied to the evaluation of a poorly differentiated neuroendocrine neoplasm of the nasal cavity masquerading as Burkitt's-like lymphoma.

The present study describes the potential usefulness of ultrastructural morphometry in diagnosis. Ultrastructural morphometric criteria were applied to the evaluation of a poorly differentiated neuroendocrine neoplasm of the nasal cavity that was initially thought to be a Burkitt's-like lymphoma (BLL). Although the nasal lesion in question failed to stain with over 50 cell lineage-relevant antibodies, it did stain for vimentin (an intermediate filament protein) and Ki-67 (a nuclear antigen associated with cell proliferation). Routine electron microscopy revealed a primitive neoplasm with abundant cytoplasmic lipid droplets and sparse dense granules with no intercellular junctions. Treatment options, which included extensive facial surgery, prompted more study. Tissue processed for the uranaffin reaction revealed sparse uranaffin-positive granules indicating the presence of true neurosecretory granules. An ultrastructural morphometric analysis of the neoplastic nuclei of this patient placed the tumor outside the morphometric domains for BLLs (18 cases) and neuroblastomas (11 cases) and within the morphometric domain of neuroendocrine carcinomas (9 cases). A greater mean standard deviation (P less than 0.05) and mean coefficient of variation (P less than 0.02) of nuclear perimeter in the neuroendocrine (NE) group related to the BLL group indicated greater nuclear pleomorphism within the NE group as illustrated in bivariate graphic displays. The possible origin of the neoplasm within the nasal mucosa is discussed.

Burkitt Lymphoma↗