We conclude that about half of patients had diagnostic constrictive bronchiolitis, or bronchiolectasis and mucus stasis consistent with more proximal luminal compromise. The fact that there were no differences between the low- and high-dose groups suggests that effects of SM are not solely dependent on the severity of exposure. The results also indicate that the diagnosis of chronic lung disease due to SM may be difficult. Surgical lung biopsy may be helpful in difficult cases, as constrictive (obliterative) bronchiolitis can be present in symptomatic patients with normal PFTs and chest HRCT.

We performed a pathologic study with further using an immunohistochemical technique (using anti-p63 and anti-CK5) on tissues obtained by open lung biopsy from 18 patients with previous exposure to sulphur mustard (SM) as case group and 8 unexposed patients (control group). The most frequent pathologic diagnosis was constrictive bronchiolitis (44.4%), followed by respiratory (22.2%) and chronic cellular bronchiolitis (16.7%) in the case group, and hypersensitivity bronchiolitis (50%) in the control group. The pathologic diagnoses were significantly different in the case and control groups (P = 0.042). In slides stained by anti-p63 and anti-CK5, the percent of stained cells and the mean number of epithelial cells were lower in the case group in comparison to the control group. This difference was significant for the mean number of cells stained by anti-CK5 (P = 0.042). Furthermore, there was a significant correlation between pathologic diagnosis and total number of cells and mean number of cells stained with anti-p63 and anti-CK5 (P  value = 0.002, <0.001, 0.044). These results suggest that constrictive bronchiolitis may be the major pathologic consequence of exposure to SM. Moreover, decrease of p63 in respiratory tissues affected by SM may suggest the lack of regenerative capacity in these patients.

Introduction: The most common site for extramedullary plasmacytomas (EMP) is the upper respiratory tract, including the oropharyngeal and nasal cavities, paranasal sinuses, and larynx. The EMPs of the head and neck area are uncommon malignancies comprising only 3% to 4% of all the plasmacytomas. Case Presentation: We presented a 78-year-old man with right facial swelling, right exophthalmos, diplopia, and decrease in visual acuity of the right eye for three weeks. A right nasal mass was identified on nasal endoscopic examination. Computed tomography scan of the paranasal sinuses revealed a mass in the right maxillary and ethmoid sinuses with orbital extension. Histopathologic examination showed plasmacytoma of paranasal sinuses. Patient received 56 Gy in 28 fractions of radiotherapy. He was well in the follow-up visits during the next one year. Conclusions: Although sinonasal EMP is rare, it is worth being considered in the differential diagnoses of paranasal malignancies. Radiotherapy is the treatment of choice for solitary EMPs of paranasal sinuses. Long-term follow-up is essential in EMPs.