E H Harley’s research while affiliated with Naval Medical Center San Diego and other places

Sinus histiocytosis with massive lymphadenopathy (SHML) is a newly recognized disorder. The etiology of this disease is unknown. An exaggerated response to an offending agent such as the Epstein-Barr virus or Klebsiella bacteria has been postulated. Its course is usually benign. Cervical adenopathy is seen in 97% of the patients, while 30% of patients have nodal involvement in other sites, and 30% have extranodal involvement. There is a 7% mortality rate that occurs primarily in patients with immunologic defects. Corticosteroids ameliorate the constitutional symptoms, but cyclophosphamide appears to have the most beneficial effect. This article presents the case of a patient with SHML who demonstrated elevated Epstein-Barr virus titers.

Nasal dermal sinus cysts, encephaloceles, and gliomas are the most common congenital nasal masses with actual or potential central nervous system connections. They can present intranasally, extranasally, or as external nasal masses with or without nasal obstruction. This paper presents several illustrative cases and reviews recent concepts in embryology and management, which hold that all congenital midline nasal masses potentially have central nervous system connections and should be managed as such.

A dorsal nasal cyst is a rare complication of cosmetic rhinoplasty. The cause of this complication is unknown; however, entrapment of nasal mucosa and subsequent growth through osteotomy sites are thought to be the basis for formation of these masses. We describe two patients with these dorsal nasal cysts and provide a review of the English-language literature. The maintenance of mucosal integrity together with the meticulous removal of debris from the operative site may prevent postrhinoplasty nasal cysts.