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Objectives Allergic fungal sinusitis (AFS) may represent an endpoint in a spectrum of sinonasal disease. Patients fulfilling criteria for a diagnosis of AFS have a poor prognosis often requiring multiple surgeries. The detection of ‘allergic mucin’ with mucus containing clusters of eosinophils and the detection of fungi by histological examination or culture is key criteria necessary for diagnosis. This study was performed to assess the strength of the association of the presence of fungi with the presence of eosinophils in a group of patients with chronic rhinosinusitis and controls. Methods Thirty patients with a clinical diagnosis of chronic rhinosinusitis and 10 individuals as control group were selected for the study. Total serum IgE level testing, nasal mucus cytology and fungal culture were performed in all subjects. Results Fungal spores were present in the nasal mucus in 14 patients with rhinosinusitis, and in 7 controls. The detection of eosinophils on cytology correlated significantly both with a clinical diagnosis of chronic rhinosinusitis (95% confidence intervals (CI) 0.34–0.81) and with the presence of fungal elements on cytology (p = 0.02). The average serum IgE level was higher in patients with fungal spores (p = 0.039). Conclusion In certain susceptible individuals inhaled fungi may provoke an eosinophilic response. This response varies from simple eosinophilic inflammation to classic allergic fungal sinusitis.

Primary cervical tuberculosis is uncommon, although its incidence has risen somewhat over the past few years. In this article, we describe a rare case in which the patient developed a dual pathology—cervical tuberculosis and a malignant squamous cell carcinoma—in a group of lymph nodes on one side of the neck. Initially, tuberculosis was diagnosed on the basis of histology and culture. However, when the patient did not respond to antituberculous drug therapy, a repeat biopsy detected the second pathology: squamous cell carcinoma. To the best of our knowledge, no such presentation has been previously reported in the world literature. We conclude that repeat biopsy might be required in cases of tuberculous cervical lymphadenopathy that do not respond to conventional antituberculous therapy.

To report outcomes of definitive radiotherapy for early-stage squamous cell carcinoma of the larynx.Retrospective outcome analysis.Tertiary referral centre.A total of 373 cases of laryngeal cancer reported in Nova Scotia from 1990 through 2001 were reviewed. All cases were classified by T stage (T1 = 137, T2 = 90, T3 = 89, T4 = 57) and affected sites (glottic = 233, supraglottic = 136, subglottic = 4). We focused on those patients with T1 and T2 cancers of both the glottis and the supraglottis who received radiotherapy as a primary modality.Eighty-eight percent (150 of 170) of T1/T2 glottic cancers were first treated with radiotherapy. Seventy-one percent (80 of 112) and 63.3% (24 of 38) of T1 and T2 glottic cancers, respectively, were controlled by radiation, with an average follow-up of 37 months. Of those T1 glottic cancers unsuccessfully treated by radiotherapy, 14 underwent surgical salvage, with 9 of these patients being free of disease following an average of 57 months. For T2 glottic cancers unsuccessfully treated by radiotherapy, five patients underwent surgical salvage, of whom four (68.4%) were free of disease after an average follow-up of 62 months. Seventy-five percent of T1 (3 of 4) and 70.6% (25 of 35) of T2 supraglottic cancers were successfully controlled by radiotherapy. Salvage surgery was attempted in five patients; however, all patients except one died of disease.Although radiotherapy is a standard treatment for early laryngeal cancers, the results of this review may suggest considering other modalities in the treatment of early laryngeal cancer.