Nasal cavity and paranasal sinuses: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
Mikael Häggström (talk | contribs)
Administrators, Editors, Image-reviewer, csmoderator, Interface administrators, Administrators, Upload Wizard campaign editors
7,148 edits
Started
 
Mikael Häggström (talk | contribs)
Administrators, Editors, Image-reviewer, csmoderator, Interface administrators, Administrators, Upload Wizard campaign editors
7,148 edits
 
(19 intermediate revisions by the same user not shown)
Line 3: Line 3:
|author2=
|author2=
}}
}}
 
{{Comprehensiveness}}
==Nasal polyps==
==Nasal or sinonasal polyps==
Look for signs of malignancy.
Look for signs of malignancy.
{{Further|Tumor evaluation}}
{{Further|Evaluation of suspected malignancies}}
[[File:Histopathology of a nasal polyp.jpg|thumb|Benign nasal polyp (not otherwise specified), consisting of hyperplastic edematous connective tissue with some seromucous glands and cells representing inflammation (mostly neutrophils and eosinophils). In early stages, the surface of the nasal polyp is covered by normal respiratory epithelium, but later it undergoes metaplastic change to squamous type epithelium (because of the constant irritation and inflammation). The submucosa shows large intercellular spaces filled with serous fluid.<ref>{{Cite book|url=https://books.google.com/books?id=Zm3jBwAAQBAJ&pg=PA168|title=Ear, Nose and Throat Histopathology|last=Michaels|first=Leslie|date=2012-12-06|publisher=Springer Science & Business Media|isbn=9781447133322|language=en|page=168}}</ref>]]
[[File:Histopathology of a nasal polyp.jpg|thumb|'''Benign nasal/sinonasal polyp''' (not otherwise specified), consisting of hyperplastic edematous connective tissue with some seromucous glands and inflammation (mostly neutrophils and eosinophils), surrounded by respiratory or squamous epithelium.<ref>{{Cite book|url=https://books.google.com/books?id=Zm3jBwAAQBAJ&pg=PA168|title=Ear, Nose and Throat Histopathology|last=Michaels|first=Leslie|date=2012-12-06|publisher=Springer Science & Business Media|isbn=9781447133322|language=en|page=168}}</ref> It can be termed '''inflammatory nasal/sinonasal polyp''' when inflammation is more pronounced.]]


Main differential diagnoses:
Main differential diagnoses:
<gallery mode=packed heights=200>
<gallery mode=packed heights=210>
File:Histopathology of inverted papilloma.jpg|Inverted papilloma, wherein the surface epithelial cells grow downward into the underlying supportive tissue.
File:Histopathology of inverted papilloma.jpg|'''Inverted papilloma''', wherein the surface epithelial cells grow downward into the underlying supportive tissue.
File:Histopathology of nasal squamous papilloma.jpg|Squamous papilloma.
File:Histopathology of nasal squamous papilloma.jpg|'''Squamous papilloma''', with acanthosis and hyperkerratosis.
</gallery>
</gallery>
In case of significant '''inflammation''':
*Take at least one high magnification look to confirm that it is mixed and that lymphocytes are not atypical (otherwise, consult hematopathology, particularly whether it could be a lymphoma, notably extranodal NK/T cell lymphoma, nasal type.
*{{Moderate-begin}}Classify as '''acute''' (with neutrophils) versus '''chronic''' (lymphocytes, eosinophils and/or plasma cells). Also look at any bone fragments for osteomyelitis.{{Moderate-end}} {{further|Osteomyelitis}}
<gallery mode=packed heights=210>
File:Histopathology of sinonasal inflammatory polyp with mixed inflammation, annotated.jpg|'''Benign chronic mixed inflammation''' of an inflammatory sinonasal polyp.
File:Histopathology of acute sinusitis.png|'''Acute inflammation''' characterized by neutrophils.
File:Histopathology of extranodal NK-T cell lymphoma, nasal type.png|'''Extranodal NK/T cell lymphoma, nasal type'''.<ref>{{cite journal| author=Takahara M, Kumai T, Kishibe K, Nagato T, Harabuchi Y| title=Extranodal NK/T-Cell Lymphoma, Nasal Type: Genetic, Biologic, and Clinical Aspects with a Central Focus on Epstein-Barr Virus Relation. | journal=Microorganisms | year= 2021 | volume= 9 | issue= 7 | pages=  | pmid=34202088 | doi=10.3390/microorganisms9071381 | pmc=8304202 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34202088  }}<br>- "This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/)."</ref> These lymphoma cells are typically monotonous, with folded nuclei, indistinct nucleoli and moderate amount of cytoplasm.<ref>{{cite web|url=https://www.pathologyoutlines.com/topic/lymphomanonBnasal.html|title=Extranodal NK / T cell lymphoma, nasal type|author=Mario L. Marques-Piubelli, M.D., Carlos A. Torres-Cabala, M.D., Roberto N. Miranda, M.D.|website=Pathology Outlines}} Last author update: 5 January 2021. Last staff update: 14 October 2021</ref>
</gallery>
==Reporting==
Example:
{|class=wikitable
| [[File:Histopathology of nasal contents with chronic inflammation.jpg|210px|left]] Right and left sinus contents, excisions:<br>Benign respiratory mucosa with chronic inflammation.<br>Bone without significant histopathologic changes.
|}
{{Bottom}}
{{Bottom}}
Retrieved from "https://patholines.org/Nasal_cavity_and_paranasal_sinuses"