Eosinophilic gastroenteritis

Eosinophilic gastroenteritis is a rare clinicopathogenic entity of an unknown aetiology in which a variety of digestive symptoms are associated to the eosinophilic infiltration in the intestinal wall. The clinical features depend on the site of eosinophilic infiltration, and the association with peripheral eosinophilia is very frequent. The radiologic findings were not specific and the diagnostic is based on the endoscopic and/or peroral gastrointestinal biopsy. The response to steroid therapy is spectacular. The etiology is unknown but we review the recent literature.     

Osteoma of the tongue

An osteoma of the tongue of a 50-year-old woman is reported. The nosology of this rare lesion is briefly described.     

Liposarcoma of the tongue

Liposarcoma is a rare tumor in the head and neck. No previous report of its occurrence in the tongue is found at the time of this writing and this prompts its presentation. Significant in its management is wide surgical excision. Irradiation may be effective in some metastases. Prognosis is best in well differentiated forms.     

Glioma of the tongue

A case of glioma of the tongue that was treated successfully by simple excision and repair is presented. It may represent neural tissue that remains in the occipital somites that differentiate into the tongue muscles. Histologically, it consists of sheets of glial tissue. The literature is reviewed, and the case is discussed.     

Eosinophilic myopathic syndromes

The purpose of this study was to develop a standardised maximal treadmill exercise test performed until fatigue in order to find reproducible markers for anaerobic metabolism, specifically adenine nucleotide degradation. Six Standardbred trotters performed an incremental maximal treadmill exercise test in 1 min steps (starting with 7 m/s) until they could no longer keep pace with the treadmill. The test was performed twice with at least one week between the tests. Heart rate was recorded and venous blood samples were obtained during the test and in the recovery period for determination of plasma lactate, hypoxanthine, xanthine and uric acid. Muscle biopsy samples (m. gluteus) were collected at rest, immediately post exercise, and after 15 min recovery and analysed for their concentrations of glycogen, creatine phosphate (CP), adenosine triphosphate (ATP), adenosine diphosphate (ADP), adenosine monophosphate (AMP), inosine monophosphate (IMP) and muscle lactate (MLa). Significant decreases in glycogen, CP and ATP and significant increases in IMP and MLa were seen immediately post exercise. None of these metabolites had returned to resting levels after 15 min of recovery. A marked increase in plasma lactate (PLa) occurred during exercise and the peak concentration (mean value = 27.2 mmol/l) was reached within 5 min of recovery. Plasma uric acid concentration did not increase during exercise but rose markedly immediately post exercise, reaching the highest level (mean value = 121.5 micromol/l) at 20-30 min recovery. The duration of the maximal test was related to peak PLa and the uric acid concentration at 30 min of recovery. A correlation was also found between the ATP and IMP concentrations immediately post exercise and the plasma uric acid concentration at 30 min of recovery. The results show that this treadmill test triggered anaerobic metabolism and also that uric acid concentration post exercise seems to be a marker for the adenine nucleotide degradation that occurs during intense exercise. No significant differences were seen in metabolic response between the 2 test occasions.     

Eosinophilic granuloma of the proximal tibial epiphysis

This is a 3-year follow-up report of an eosinophilic granuloma of bone occurring in a growing epiphysis. The lesion occurred in a 6-year-old boy and is only the third such case reported in the literature. Eosinophilic granuloma should be considered in the differential diagnosis of lytic lesions of the epiphysis in childhood.     

Angiomyolipomatous hamartoma of the tongue

To examine the role of the liver in lipopolysaccharide (LPS)-induced hypophagia, we investigated the effect of hepatic portal and vena cava infusions (1 mL/30 min) of LPS (100 microg/kg of body weight) on feeding in rats. LPS infusion significantly reduced food intake when administered via either the hepatic portal vein or the vena cava. Both the magnitude and time course of this hypophagia were similar regardless of the infusion route. As in previous experiments of ours in which LPS was administered by intraperitoneal (i.p.) injection, LPS reduced food intake by decreasing meal frequency, without affecting meal size or duration. The results suggest that peripherally administered LPS does not act primarily in the liver to reduce food intake.     

Osteoma of the base of the tongue

A 14-year-old girl developed a firm mass at the base of the tongue. Computed tomography indicated marked density suggesting either a foreign body or bony tissue. A thyroid scan confirmed the presence of a normally sized and positioned gland. The mass was removed in toto and found to be an osteoma. This is the first report of a case in which the diagnosis of this rare developmental lesion of the tongue was achieved preoperatively based on clinical and radiologic information. This experience should lead to greater awareness of this entity in the future. Recognition of this entity in the pediatric age group is especially useful in avoiding misdiagnosis of other, potentially more aggressive types of tongue mass lesions. Our case demonstrates that it is possible to detect this entity using computed tomography. The dense calcification is truly characteristic of the tumor and may be relied upon to exclude alternative soft tissue mass lesions. While other forms of osseous and cartilagenous neoplasms, such as extraskeletal osteosarcoma and chondrosarcoma, have been reported arising in the tongue, their malignant nature should otherwise be readily apparent. Osteoma of the tongue is the favored diagnosis when mature bone tissue is imaged at the base of the tongue.     

Solitary fibrous tumour of the tongue

In a review of pulmonary tumors diagnosed at our institute from 1976 to 1995, we found 20 malignant and 12 benign rare tumors, which accounted for 0.57 and 0.34% of all pulmonary tumors, respectively. The histological types of these rare malignant tumors were malignant lymphoma (6/20), carcinosarcoma (3/20), mucoepidermoid carcinoma (2/20), bronchial gland mixed tumor (2/20), adenocystic carcinoma (1/20), myoepithelioma (1/20), leiomyosarcoma (1/20), epitheloid hemangioendothelioma (1/20), hemangiopericytoma (1/20), malignant melanoma (1/20) and choriocarcinoma (1/20). Benign rare tumors involved papilloma (3/12), lipoma (3/12), leiomyoma (3/12), adenoma (1/12), fibroma (1/12), and meningioma (1/12). The clinical and pathological features of malignant tumors were roughly the same as those of common pulmonary carcinomas. In contrast, benign tumors were never larger than 3 cm and were more commonly located in the central parts of the lung, which explained the relatively frequent symptoms of wheezing and fever associated with obstructive pneumonia.     

Prominent pigmented fungiform papillae of the tongue

Prominent pigmented fungiform paillae of the tongue are characterized clinically by prominence and pigmentation confined to these papillae and histopathologically by melanophages in the lamina opriae. A 45-year-old Asian woman had dark erythematous papules exclusively involved with fungiform papillae on the anterior lateral dorsal aspect of the tongue and hyperpigmentation on the lip. Histologic examination revealed many melanophages in the subepidermal area within the fungiform papillae. Her skin lesions improved moderately following two months of treatment for anemia.     

Rhabdomyosarcoma of the tongue in a dog

A lingual rhabdomyosarcoma was diagnosed in a six-year-old Staffordshire bull terrier with clinical signs of dysphagia. The unsuccessful response to initial chemotherapy, to surgical resection and subsequent surgical resection and radiation therapy is documented. The accurate diagnosis and prognosis of such tumours is also discussed. Lingual rhabdomyosarcoma has not previously been reported in the dog.