Cervical squamous carcinoma metastatic to the central nervous system is an uncommon occurrence. Only eight such cases are reported in the literature. This is a case report of such a metastasis with emphasis on the cytologic features seen in the tumor cells found in the spinal fluid, along with a review of the literature.
Background. Despite the widespread view that important clinical and etiologic differences exist between histologic categories of lung cancer, few studies have examined the accuracy of hospital‐reported pathologic diagnoses of lung cancer.
Methods. A review of pathologic material and an assessment of survival patterns were conducted in conjunction with a recently completed case‐control study of lung cancer among nonsmoking women in Missouri. Using established protocols, tissue slides from tumors of 482 patients were reviewed by 3 pathologists.
Results. Adenocarcinoma was the most common histologic type among former smokers and lifetime non‐smokers. The overall agreement rate between the original and review diagnoses was 65.6%. The positive predictive value ranged from 0.33 for bronchioalveolar carcinomas to 0.84 for adenocarcinomas. Agreement rates for small, medium, and large hospitals were 63.1, 66.6, and 66.2%, respectively. Survival rates were highest for bronchioalveolar carcinoma and lowest for small cell carcinoma.
Conclusion. Given the importance of lung cancer to public health and the need to examine risk by histologic type, these data indicate that pathologic review of registry‐reported lung cancer cases may be an important component of large scale studies of etiology.
Severe recalcitrant sinusitis with orbital involvement may be the initial presentation of NK/T-cell lymphoma. Ulcerative or necrotic lesions in the midline of the head and neck should raise concern for this disease. In addition to radiographic and laboratory testing, large biopsies should be taken for immunohistochemical analysis to achieve diagnosis and guide further management.
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