Phenotype identification and detection of the EBV latent gene by immunohistochemistry with monoclonal antibodies, and detection of EBER RNA by in situ hybridization were performed in nasal NK/T-and T-cell lymphomas diagnosed from 1991 to 2003. Detection of the T-cell receptor (TCR) gene rearrangement by PCR was also performed in three of the cases. Of the seven cases of T-cell lymphoma, four were positive for CD56 and were possibly cases of NK/T-cell lymphoma. In relation to the detection of the EBV-encoded genes, while strong positivity was noted for EBNA1 and EBER, all the cases were negative for EBNA2 and ZEBRA. Our study results indicate that nasal NK/T-cell lymphomas strongly possess the characteristics of both NK-and T-cells.

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Low-dose long-term treatment of 14-membered ring macrolide antibiotics has been reported to be effective in the treatment of various chronic respiratory diseases, including chronic sinusitis (low-dose macrolide therapy). Clarithromycin (CAM) is the most commonly used drug for low-dose macrolide therapy, however only few data about the tissue distribution of the drug in patients are available. To evaluate the tissue distribution of CAM, the serum and tissue concentrations of the drug were measured in 5 chronic sinusitis patients during macrolide therapy (200 mg/day for 14 days or more). Three hrs after oral administration of CAM (200 mg), nasal polyp and serum specimens were obtained from the patients at the time of endoscopic sinus surgery. The serum and nasal polyp concentrations of both CAM and 14-hydroxyclarithromycin (14-OH CAM ; hydroxylation at 14-position), which is an active metabolite, were measured. The concentrations in the nasal polyps (median, n=5) were 7.00 μg/ml for CAM and 1.36 μg/ml for 14-OH CAM, which were 12.3 times and 9.9 times the serum concentrations, respectively. These results confirmed that the concentrations of CAM are high in nasal polyps, consistent with the high clinical efficacy of the drug.

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Malignant tumors of the external auditory canal (EAC) are comparatively rare. We report a case of adenoid cystic carcinoma of the EAC. A 38-year-old woman with a mass occluding the EAC underwent local postauricular excision, approach. The capsulated tumor consisted of noninvasive fibrous tissue exhibiting a typical cribriform pattern. Pathological findings indicated grade I adenoid cystic carcinoma with histologically clear margins. This patient thus requires careful follow-up.

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A 24-year-old male presented with repeated episodes of nasal bleeding and obstruction on the right side. Radiological examination showed a mass in the right nasal cavity and maxillary sinus with bone destruction. Based on the suspected diagnosis of organized hematoma, we performed endoscopic endonasal surgery.
Histopathological examination demonstrated a hematoma with clotted blood, fibrin and granulations, clinically diagnosed as organized hematoma. Although there are difficulties in discriminating this condition from malignant tumors, it is possible to diagnose organized hematoma by local examination and radiological examinations.
With the increasing trend towards treatment by endoscopic endonasal surgery, the indications of this procedure should be further clarified.

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[in Japanese]

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