Abstract:
The nasal cavity and paranasal sinuses are covered with ciliated respiratory mucosa of ectodermal origin, known as Schneiderian epithelium, which can give rise to different types of sinonasal carcinomas. A 42-year-old woman with a history of nasal polypectomy 3 years previously presented with nasal obstruction and rhinorrhea. She was found to have a papillary mass involving the left nasal cavity, and the left maxillary and ethmoidal sinuses by radiologic examination. She underwent endonasal resection under the diagnosis of oncocytic papilloma. The resected specimen showed exuberant invasive growth of papillary or inverted architectures of epithelial cells. The neoplastic cells were very bland, showing a round to polygonal shape, low nuclear-to-cytoplasmic ratio, abundant oncocytic cytoplasm, uniform nuclei, indistinct nucleoli, and scarce mitosis. The overall features were identical to those of a recent report of a low-grade papillary Schneiderian carcinoma. The main differential diagnosis is Schneiderian papilloma, and awareness of this novel entity is important for its proper treatment.
摘要:
鼻腔和鼻旁窦覆盖有外胚层起源的纤毛呼吸道粘膜,被称为Schneiderian上皮,可以引起不同类型的鼻腔鼻窦癌。一名42岁女性,3年前有鼻息肉切除术史,出现鼻塞和鼻漏。她被发现有一个累及左鼻腔的乳头状肿块,放射学检查左侧上颌窦和筛窦。在诊断为嗜酸细胞乳头状瘤的情况下,她接受了鼻内切除术。切除的标本显示上皮细胞乳头状或倒置结构旺盛的侵袭性生长。肿瘤细胞非常温和,显示圆形到多边形的形状,核质比低,丰富的嗜酸细胞细胞质,均匀的原子核,模糊的核仁,和稀少的有丝分裂。总体特征与最近报道的低度乳头状Schneiderian癌的特征相同。主要鉴别诊断为Schneiderian乳头状瘤,意识到这个新颖的实体对于它的正确治疗很重要。