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Case 5
“Jugular-tympanic lesion”
Francesca Bono – Desio Hospital
(pictures by Dr. Bono)
Clinical history
67 y.o. woman with a history of earaches. ORL diagnosis of chronic hyperplastic otitis of the right ear and mixed hypoacusia.
The patient underwent a tympano-plastic surgery which was interrupted after the demolition of the posterior wall of the external
auditory canal due to a hemorrhagic polypoid neoformation.
A fragment of the neoformation was taken for an intraoperative consultation (Pict. 1).
Intraoperative diagnosis
Vascular neoplasia (begnin) (Pict. 2 - Pict. 3)
Descrizione microscopica
The formation was composed of fibro-muscular stroma with a rich capillary network (Pict. 4)
in which monomorphic cells with a slight cytoplasm were evidenced, no atypia and no mitosis
(Pict. 5 -
Pict. 6).
The neoplastic cells were arranged mostly in nests or cords and related to the surrounding vascular spaces
(Pict. 7).
The immunohistochemistry stains for CD34 and CD31 (Pict. 8)
evidenced the rich vascular component and the immunohistochemistry stains for the S-100 protein
(Pict. 9) evidenced the substentacular cells.
The neoplastic cells were negative for cytocheratin (Pict. 10)
and strongly positive for NSE (Pict. 11)
and synaptophysin (Pict. 12).
Diagnosis
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