Localized Nasopharyngeal Amyloidosis: A Clinicopathologic Series of 7 Cases with a Literature Review
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REVIEW PAPER
Localized Nasopharyngeal Amyloidosis: A Clinicopathologic Series of 7 Cases with a Literature Review Georgios Sakagiannis1 · Evangelos Giotakis2 · Lester D. R. Thompson3 Received: 2 October 2017 / Accepted: 13 December 2017 © Springer Science+Business Media, LLC, part of Springer Nature 2017
Abstract Localized nasopharyngeal amyloidosis is an extremely rare entity with only 25 cases described in the English and German literature. We present a case series of seven patients with localized nasopharyngeal amyloidosis and combine the findings with a thorough review the literature. Keywords Nasopharyngeal amyloidosis · Amyloidosis · Palatine tonsils · Nasopharynx
Introduction Amyloidosis is a rare clinical entity that represents a group of disorders. It can be broadly classified as systemic or localized disease. Localized nasopharyngeal amyloidosis is an extremely rare entity with only approximately 25 cases described in the English and German literature. A case series of seven patients with localized nasopharyngeal amyloidosis and a thorough review of the literature are presented.
Materials and Methods A search of the histology records in the University Hospital Attikon in Athens, Greece was performed and combined with the consultation cases of one of the authors (LDRT). All patient records with diagnosis of amyloidosis were retrieved and only patients with localized amyloidosis were included in this case series. A search of PubMed for cases classified as nasopharyngeal amyloidosis, amyloidosis, palatine tonsils, and/or nasopharynx were used to find studies published in English and German. Further reports * Georgios Sakagiannis [email protected] 1
Ear, Nose, Throat and Head and Neck Department, Attikon University Hospital, Athens, Greece
2
Ear, Nose, Throat, Head and Neck Department, Hippokration University Hospital, Athens, Greece
3
Department of Pathology, Woodland Hills Medical Center, Los Angeles, CA, USA
were identified during the literature review. Duplicate papers were excluded, and the total number of 897 was reduced to 32 relevant papers. The case materials were histologically reviewed, specific studies to confirm amyloidosis evaluated, and a comparison made to the pertinent literature.
Case Reports Case 1 A 74 year old Caucasian woman presented with a 1 year history of nasal obstruction and a sense of postnasal drip. Flexible nasendoscopy revealed the presence of a diffusely enlarged mass located in the nasopharynx that seemed to partially occlude the eustachian tube orifices and gave the impression of enlarged adenoids. The rest of clinical examination was unremarkable. A head and neck computed tomography scan confirmed the presence of a mass (Fig. 1), with a concurrent negative chest study. Biopsy of the lesion under local anesthesia and endoscopic guidance was followed by a wide excision. Both histopathology samples were diagnosed as amyloidosis (Figs. 2, 3, 4). After thorough clinical and laboratory evaluation, no systematic involvement was identified. Approximately 2 ye
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