In Japan, malignancy of the oropharynx constitutes about 4-7% of all head and neck malignancies, which is much less frequent when compared with the incidence among Caucasian people. Although the oropharyngeal region is covered with squamous cell epithelium, it includes lymphoid tissues such as palatine tonil and linguar tonsil which form the Waldeyer's ring. Accordingly a variety of tumors can be seen in this region. Histopathologically well-differentiated squamous cell carcinoma is most frequent, which is followed by malignant lymphomas. Other tumors in this region include poorly differentiated squamous cell carcinoma, adenoma and mixed tumors. Many malignant lymphomas are reticulum cell sarcoma. Others includelymphsarcoma and Hodgkin's disease. Choice of treatment should be based upon the histopathological features of the tumor, that is, radiation therapy would be better for malignant lymphomas and undifferentiated carcinomas, while well differentiated squamous cell carinoma is usually better treated by a combination of irradiation and surgery.
Vasoformative tumors of the mucous membrane of the nose consistute a distinctive, yet clinically and often pathologically fluctuating, type of lesion. There are many unsettled questions concerning the exact nature of these lesions, the neoplastic potentiality and implications, and histopatholgocial features. The benign tumor of the endothelial cells is hemangioma, but the neoplastic nature of the lesion is being challenged. In the nasal cavity there are several lesions that present microscopic features very similar to those of true hemangiomas; the granuloma pyogeriicum is a tumor-like lesioncharacterized by proliferation of endothelial cells and often indistinguishable from true hemangiomasunder the microscope. Hemangioma may also repreesent a variety of histopathological patterns appearing like an inflammatory lesion that is traumatic in origin. This study was undertaken in an attempt to find an etiologic factor which might account for the development of the “bleeding polyp”. A review of 50 cases of bleeding polyps of the nasal cavity and the paranasal sinuses revealed only 18 cases of hemangioma. Furthermore, hemangiomas, whether malformation or neoplasmas, are invariably classified according to the histopathological appearance of the primary architecture into the following three categories; capillary, cavernous and hypertrophic or juvenile.
The authors report a case of Shy-Drager syndrome in a 51-year-old male with complaints of dizziness, syncope and incontinence. Neuro-otological examination on this patient revealed positional nystagmus, abnormal waves in OKP test and ETT, abnormal findings in standing test, stepping test and past-pointing test, normal caloric test and dysfunction of autonomic nerves. The authors discussed the significance of the neuro-otological tests, particularlly OKP test and ETT, in understanding the pathogenesis of the disease and the mechanism of development of various symptoms in this disease.
A five-year follow up study was carried out in 164 nasal allergy patients who were treated by specific immunotherapy. The result of the therapy were evaluated by a questionnaire or interview on nasal symptoms and assessed as good when the symptoms disappeared or so slight, as not to interfere with the patients' daily life. Good results were observed in 80% of house dust allergy cases, 75% of mold allergy, and in 25% of pollinosis cases. In perennnial nasal allergy, good results were obtained frequently from the pateints whose symptoms were slight or moderate and improved within 6 months after the treatment, but were obtained only occasionally from the patients whose symptoms consisted of severe nasal obstruction or whose offending allergens were misdiagnosed. The good results lasted for 5 years in the majority of patients who were treated continously for more than 2 years, and showed stable and good conditions at the time of cessation of the treatment. In pollinosis the addition of other treatments to the present immunotherapy was necessary for obtaining good results.
Thirty-three cases of head and neck malignancies were treated with extracts from tuberculosis bacilli (Maruyama-Vaccine, or SSM) at the Department of Otolaryngology, Dokkyo Medical College and the results are reported together with the data on changes in immunoglobulin values. The head and neck malignacies included 13 cases of cancer, 5 cases of sarcoma, 3 cases of melanoma and one case each of malignant granuloma and mixed tumor. The data were collected from cases after elapsed periods of more than 6 months following conclusion of the treatment with SSM. Twelve cases (52.1%) survived 2 to 3 years, and four cases died. The other cases were within one year after conclusion of the treatment. The diseases of the four cases that died during the observation period were malignant mixed tumor of the maxillary sinus, carcinoma of the maxillary sinus, melanoma of the nose and lung cancer. Those cases that survived 2 to 3 years showed positive DNCB skin reaction and an increase in a2-globulin differential and also in IgG level.
Helper T cell function was evaluated by estimating the number of immunoglobulin producing cells from poke weed mitogen stimulated B cells being helped with test T cells. Decrease of the function was observed in about 40% of the cases regardless of the duration of the illness or the severity of clinical symptoms. There was a reverse relationship between the helper T cell function and serum IgE level. From the experimental result, it was indicated that helper T cell function of major immunoglobulin abnormality of T cell system exists in nasal allergy especially with increased IgE.