Humoral and cellular immunity parameters in children before and after adenotonsillectomy

Adenoids and tonsils are active lymphoid organs and play an important role against invading antigens of upper aerodigestive tract in children. The present study analyzes the changes in cellular and humoral immunity of children six months after adenotonsillectomy. The study population consisted of 30 children whit chronic adenotonsillar hypertrophy and 30 age-matched healthy children. In all children serum level of IgM and IgG, percentage of T lymphocytes (CD3), T helper cells (CD4), T cytotoxic cells (CD8) and B lymphocytes (CD20) were measured before surgery. These parameters were remeasured in patients 6 months after adenotonsillectomy. Before the operation, a reduction in percentage of T lymphocytes (CD3),TCD4,TC8 and B CD20 was seen compared to control group. This reduction was only significant in T lymphocytes (CD3).The serum IgM and IgG levels were not different in two groups. Six months after operation, the percentage of lymphocytes T CD3, T CD8 and BCD20 was increased and reached the control group. The IgM level was also significantly decreased in patients after operation. Our results indicate that cellular and humoral immunity decreases in children with chronic adenotonsiller hypertrophy preoperatively and increases to healthy children level, six months postoperatively. It means that chronic adenotosillar hypertrophy affect some parameters of cellular and humoral immunity and adenotonsillectomy by removing chronic stimulations and reverses these changes without any negative effect on immune function of patients. © 2007 Tehran University of Medical Sciences. All rights reserved

Aggressive Adenoid Cystic Carcinoma of Maxillary Sinus in a 43-Year-Old Male: Rare Case Report and Review of Literature

Adenoid cystic carcinoma (ACC) is a rare malignant tumor, mostly involving the minor salivary glands. Herein, we present a case of ACC in a 43-year-old man with symptoms of dental abscess as the initial presentation of the tumor. In spiral computed tomography (CT) scan, soft tissue mass with the erosion of maxillary sinus wall on the right side of the alveolar ridge was evident. Histopathological examination of the excised tumor with immunohistochemical studies (C-kit, Vimentin, pan-cytokeratin, p53, p63, and ki67 positive reaction) confirmed grade 2 ACC in the maxillary sinus. The patient underwent hemimaxillectomy and right-neck dissection. Due to the extension of tumor cells excessively into the surrounding tissues and involvement of orbital bone, complete and total resection of the tumor with safe margins could not be done. After surgery, adjuvant radiotherapy was considered for the patient. At the end of treatment, the patient lost his eye vision. Seventeen months from initial diagnosis, he was still alive without lung or distant metastasis

Prognostic Factors and Survival Time in Patients with Small Bowel Tumors: A Retrospective Observational Study

This study examines survival time in patients with small bowel tumors and determines its contributing factors. In this retrospective analytical study, the medical records of 106 patients with small bowel cancer (from 2006 to 2011) were investigated. The patients’ data were extracted, including age, gender, clinical presentation, location of tumor, histological type, grade of tumor, site of metastasis, and type of treatment. The Kaplan-Meier test was used to estimate the overall survival time and the Log-rank test to compare the survival curves. The Cox regression was also used to evaluate the effect of the confounding variables on survival time. This study was conducted on 106 patients with a median age of 60 years (Min: 7, Max: 87). The tumor types included adenocarcinoma (n=78, 73.6%), MALToma (n=22, 20.8%), neuroendocrine tumors (n=4, 3.8%), and sarcoma (n=2. 1.8%). Grade 3 adenocarcinomas had a significantly lower survival time (HR: 1.48, 95% CI: 0.46-2.86; P=.001). Combined therapy (chemotherapy and surgery) vs. single-therapy (only surgery) had no significant effects on the survival of the patients with MALToma (5 vs. 3 months, 95% CI: 1.89-5.26; P=.06). There were no significant differences between the survival time in adenocarcinoma and MALToma (12 vs. 20 months, 95% CI: 6.24-24.76; P=.49). Tumor grade was the only independent prognostic factor that affected survival in adenocarcinoma. The patients diagnosed with MALToma in the study also had a poor prognosis, and the type of treatment had no significant effect on their survival

Kaposiform hemangioendothelioma: report of a case unresponsive to usual medical treatments

Kaposiform hemangioendothelioma is an aggressive endothelial-derived spindle cell neoplasm that occurs nearly exclusively during childhood and teenage years. The lesion grows rapidly and is often associated with Kasabach-Merritt syndrome

Desmoplastic Infantile Astrocytoma in a 47-day Old Male Infant with Four-year Follow-up: A Rare Case Report and Literature Review

Desmoplastic infantile astrocytoma/ganglioglioma (DIA/DIG) is a rare mixed neuronalglial solid cystic brain tumor found in infantile cerebral hemispheres. The main presentation of the tumor is the rapidly enlarging of the head circumference with hydrocephalus and seizure. DIA is classified as a WHO Grade 1 brain tumor but, due to the rarity of the tumor, few studies are available on tumor survival and prognosis. Herein, we report a 47-day-old male infant diagnosed with DIA and the four-year follow-up

Near missed diagnosis of Merkel cell carcinoma in a young immunocompetent woman with a recurrent left‐arm mass: A case report

Key Clinical Message Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine cancer that primarily affects the elderly, Caucasians, and the immunocompromised. We present a rare case of an immunocompetent young Iranian (non‐Caucasian) female with a small nodule on her left arm. The lesion was initially misdiagnosed as an infected cyst and was treated with antibiotics for 20 days before being surgically removed. Unfortunately, the lump regrew rapidly 2 weeks later, when she had a biopsy, which revealed stage III MCC. She was then treated with adjuvant chemoradiotherapy after a thorough surgical resection of the tumor. Despite the fact that she was in remission after completing chemotherapy courses, she developed neutropenic fever, sepsis and died from septic shock. This case emphasizes the necessity of early clinical diagnosis of MCC and obtaining a biopsy with histopathologic evaluation of rapidly evolving skin lesions suggestive of malignancy

A rare case of primary Ewing's sarcoma presenting in the posterior nasal cavity with extension into the sphenoid sinus and a review of the literature

Ewing's sarcomas/primitive neuroectodermal tumors (PNET) are a group of tumors characterized by small round cells that rarely affect the bone and soft tissues of the nasal cavities. Herein, we describe the case of a 38-year-old man who presented with a one-year history of epistaxis, headache, hyposmia, anosmia, night sweats, weight loss, hearing loss, dysphagia, and nasal blockage. A computed tomography (CT) scan and magnetic resonance imaging (MRI) studies revealed a lesion in the posterior nasal cavities with extension into the sphenoid and ethmoid sinuses. Histological examination of a biopsied specimen obtained via flexible fiberoptic endoscopy showed small dark round cells with scanty cytoplasm arranged in solid nests and pseudorosette formations. The diagnosis of Ewing's sarcoma was confirmed by the positive reactive pattern of the neoplastic cells for CD99 by immunohistochemistry studies and also identification of a chromosomal translocation of FLI1 in PCR studies. Cervical lymph nodes and bone marrow involvement were also observed. The patient was treated by adjuvant chemotherapy including vincristine, endoxan, and adriamycin for 6 cycles followed by radiotherapy (eleven courses). Unfortunately, before completion of treatment, the patient died due to disease progression and brain metastasis