PMC3615940_01
Computed tomography showing occupation of the maxillary sinuses, ethmoidal cells and sphenoidal sinus by a hyperdense soft tissue mass. (A) Coronal plane. (B) Sagittal plane. (C) Axial plane.
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A computed tomography (CT) scan was performed, showing occupation of the maxillary sinuses, ethmoidal cells and sphenoidal sinus by a hyperdense soft tissue mass (Figure 1).
Photomicrographs demonstrating a dense polymorphous cellular infiltrate consisting of small and medium-sized lymphocytes with atypical nuclear characteristics (irregular nuclear outline and absence of nucleoli), abundant reactive macrophages, plasma cells, neutrophils, eosinophils and new blood vessels. (Hematoxylin and Eosin, (A) 100x, (B) 200x).
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Non-necrotized segments showed extensive ulceration of the covering epithelium and a dense polymorphous infiltration consisting of lymphoid cells such as small and medium-sized lymphocytes with atypical nuclei characteristics (irregular nuclear outline and absence of nucleoli), abundant reactive macrophages, plasma cells, new blood vessels, neutrophils and eosinophils (Figure 2).
Immunohistochemical analysis. The neoplastic lymphocytes are positive for the T-cell markers CD43 (A), CD2 (B) and CD7 (C), as well as for the NK cell marker CD56 (D).
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Immunohistochemical analysis (Table 1) revealed that the atypical lymphoid cells were positive for the T-cell markers CD43, CD2 and CD7, and many of these cells were also positive for the NK-cell markers CD56, perforin and granzyme B, as well for EBV LMP1 and CD95 (Figure 3).
Removable partial denture with obturator was fabricated to relieve functional problems caused by the oronasal defect. (A) A 6x4cm postoperative oronasal defect creating problems of regurgitation of food and fluids into the nasal cavity. (B) Removable partial denture with obturator. (C and D) Insertion of the partial denture in the maxilla and the oronasal defect.
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Thirty months after treatment, a removable partial denture with obturator was fabricated and inserted to relieve problems of regurgitation of food and fluids into the nasal cavity caused by the oronasal fistula (Figure 4).