Rosai–Dorfman disease (RDD), a rare, benign, self-limiting histiocytic proliferative disorder, can be encountered in both nodal and extranodal locations, and fine needle aspiration (FNA), a simple, accurate and economic tool, has been widely used for the diagnosis of superficial and deep-seated lesions. Familiarity with the cytomorphologic features of RDD is important as prognosis and treatment are quite different from other benign or malignant diseases for which it may clinically masquerade. Although large numbers of RDD cases have been reported, review of the literature has revealed 49 reported cases of RDD diagnosed by FNA. Here, we report a case of RDD with nasal and sinus involvement. The patient was seen at our institution, carrying a diagnosis of inflammatory pseudotumor rendered by an outside institution, based on material obtained by nasal and sinus surgical biopsies. Cervical lymph node FNA performed at our institution revealed typical features of RDD. The case, as well as a brief review of the literature and 49 RDD cases with FNA cytology, will be discussed.
A four-grade classification scheme for intracranial arteriovenous malformations (AVM's) is proposed. Grading is based on the size of the AVM; its location and depth; its arterial supply; and its venous drainage. Each of these aspects is divided into four grades with respect to the difficulty it poses for surgical excision. A description of the grading system and its application is given. This grading scale has been correlated with the operative morbidity and mortality in 100 cases of excised intracranial AVM's. The results show that the higher the grade of AVM, the greater the risk of surgical morbidity and mortality. This grading scale is simple and easy to apply. It can guide neurosurgeons in selecting AVM patients suitable for operation, in determining the best type of operation to perform, and in predicting operative difficulties as well as postoperative results.
Sixteen patients with arteriovenous malformations (AVM's) located in the striatothalamocapsular region were treated microsurgically at the Hau Shan Hospital, Shanghai. These AVM's had a tendency to bleed intracerebrally and typically presented with hemiplegia, hemianesthesia, and hemianopsia. Angiographically the lesions were primarily located in the triangle of Reil. Postoperative outcome was not as good as that of AVM's in other locations, but the operation may have prevented the risk of further hemorrhage. This report details the operative technique used and the clinical course in this group of patients.
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