Evidence of SARS-CoV-2 in nasal brushings and olfactory mucosa biopsies of COVID-19 patients

The aim of the present study is to detect the presence of SARS-CoV-2 of patients affected by COVID-19 in olfactory mucosa (OM), sampled with nasal brushing (NB) and biopsy, and to assess whether a non-invasive procedure, such as NB, might be used as a large-scale procedure for demonstrating SARS-CoV-2 presence in olfactory neuroepithelium. Nasal brushings obtained from all the COVID-19 patients resulted positive to SARS-CoV-2 immunocytochemistry while controls were negative. Double immunofluorescence showed that SARS-CoV-2 positive cells included supporting cells as well as olfactory neurons and basal cells. OM biopsies showed an uneven distribution of SARS-CoV-2 positivity along the olfactory neuroepithelium, while OM from controls were negative. SARS-CoV-2 was distinctively found in sustentacular cells, olfactory neurons, and basal cells, supporting what was observed in NB. Ultrastructural analysis of OM biopsies showed SARS-CoV-2 viral particles in the cytoplasm of sustentacular cells. This study shows the presence of SARS-CoV-2 at the level of the olfactory neuroepithelium in patients affected by COVID-19. For the first time, we used NB as a rapid non-invasive tool for assessing a potential neuroinvasion by SARS-CoV-2 infection

A parathyroid cancer with soporous state, depression, and severe cognitive decline in acute renal failure

Key Clinical Message Soporous state in acute renal failure represent an atypical presentation of parathyroid cancer. Complete prompt investigations and diagnosis have a fundamental role in the management of this disease Abstract This report describes a case of parathyroid carcinoma (PC) with an uncommon first clinical presentation: soporous state, depression, and severe cognitive decline in association with acute renal failure. After discovering extremely high serum calcium and parathyroid hormone (PTH) levels, the diagnosis of primary hyperparathyroidism (pHPT) was made and a surgical en bloc resection was performed. After the surgical intervention, the histological examination revealed the presence of a malignant parathyroid disease, thus confirming our first preoperative suspicion

Is there any association between Nasal Polyposis and Osteoma? A retrospective analysis of incidence of Paranasal Sinus Osteoma among 600 patients treated for Nasal Polyposis

Osteoma is a rare benign lesion of the skull, with an incidence of 0.6% of all benign tumours of paranasal sinuses. It is commonly asymptomatic, and mostly diagnosed incidentally at the imaging. The most frequent disturbs are: headache, nasal discharge and symptoms of inflammation.Osteoma is often associated with nasal polyposis and mucocele, which are usually considered as secondary lesions. Contrariwise, in our cases, we are prone to consider the osteoma as secondary to the inflammation associated with polyposis and mucocele. The physiopathology of these diseases was therefore reviewed to explain a possible relationship.We conducted a retrospective analysis in our ENT division from January 2010 to December 2016.&nbsp;In our cohort of 600 patients with nasal polyposis we found 20 cases of osteoid osteoma with an incidence of 3,33%. The mean age was 45,7 (+/-16,7 y.o.), with a Male/Female ratio of 2,3:1. In twelve cases the osteoma was located in the frontal sinus (70%), seven were implanted on the lateral part of the ethmoid roof (35%), and one extended from the ethmoidal to the frontal sinus (5%). The average tumour size was 11.04 ± 8,16 mm (range 2,88 mm– 19,2 mm). All patients underwent CT scan, clinical evaluation and ESS with histological examination.The collected data may suggest that chronic mucosal inflammation can induces bone modification and eventually lead to osteomas.We can hypothesize that paranasal sinus osteomas could represent a complication of nasal polyposis. Further investigations are needed to confirm this hypothesis.</p