Hitoshi Sakuma

Acquired Cholesteatoma without any Connection to the Tympanic Membrane

Cholesteatoma is classified as : primary acquired cholesteatoma, secondary acquired cholesteatoma and congenital cholesteatoma. Usually, the matrix of acquired cholesteatoma cornmunicates with the tympanic membrane. Recently, we encountered a case of acquired cholsteatoma not involving the tympanic membrane. The case was a 64-year-old male who died of thyroid cancer on August 29, 1991. After processing by conventional celloidin embedding, specimens were cut horizontally into 25 pm sections. Every 10th section was stained with hematoxylin-eosin and examined for histopathology under a light microscope. We also performed computer-aided three-dimensional reconstruction and immunohistochemical study. Right temporal bone. Cholesteatoma without any connection to the tympanic membrane was found. Cholesteatoma with desquamated epithelial debris was seen in the antrum. The matrix of cholesteatoma showed autolytic change with infiltration by giant cells. The tympanic membrane formed a dimeric membrane which was the result of a healed perforation. The three-dimensional reconstruction confirmed that the cholesteatoma was not connected with tympanic membrane. By immunohistochemistry, the matrix of cholesteatoma was positive for involucrin, but granulation in tympanic cavity was negative. From these findings it was considered that this cholesteatoma was not congenital but acquired, and that the matrix of the cholesteatoma in the neighbourhood of tympanic membrane had disappeared.

Malignant Lymphoma of the Parotid Gland Associated with Sj^|^ouml;gren's Syndrome; A Case Report

A rare case of malignant lymphoma of the parotid gland associated with SjOgrens syndrome is reported along with a review of the medical literature. A 67-year-old female complained of a mass in her left parotid region and was admitted to our hospital. We failed to precisely diagnose the tumor despite various preoperative examinations. The tumor was removed surgically and histological examination of the resected tumor showed nonHodgkins lymphoma. She was treated with chemotherapy and has had no recurrence for eighteen months after treatment.