Nasal cavity and paranasal sinuses

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Author: Mikael Häggström [note 1]

Nasal or sinonasal polyps

Look for signs of malignancy. Further information: Evaluation of suspected malignancies

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.[1] It can be termed inflammatory nasal/sinonasal polyp when inflammation is more pronounced.

Main differential diagnoses:

  • Inverted papilloma, wherein the surface epithelial cells grow downward into the underlying supportive tissue.
    Inverted papilloma, wherein the surface epithelial cells grow downward into the underlying supportive tissue.
  • Squamous papilloma, with acanthosis and hyperkerratosis.
    Squamous papilloma, with acanthosis and hyperkerratosis.

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.

  • Benign mixed inflammation of an inflammatory sinonasal polyp.
    Benign mixed inflammation of an inflammatory sinonasal polyp.
  • Extranodal NK/T cell lymphoma, nasal type.[2] These lymphoma cells are typically monotonous, with folded nuclei, indistinct nucleoli and moderate amount of cytoplasm.[3]
    Extranodal NK/T cell lymphoma, nasal type.[2] These lymphoma cells are typically monotonous, with folded nuclei, indistinct nucleoli and moderate amount of cytoplasm.[3]

Reporting

Example:

Right and left sinus contents, excisions:
Benign respiratory mucosa with chronic inflammation.
Bone without significant histopathologic changes.|}

Notes

  1. ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. ↑ Michaels, Leslie (2012-12-06) (in en). Ear, Nose and Throat Histopathology . Springer Science & Business Media. p. 168. ISBN 9781447133322. 
  2. ↑ Takahara M, Kumai T, Kishibe K, Nagato T, Harabuchi Y (2021). "Extranodal NK/T-Cell Lymphoma, Nasal Type: Genetic, Biologic, and Clinical Aspects with a Central Focus on Epstein-Barr Virus Relation. ". Microorganisms 9 (7). doi:10.3390/microorganisms9071381. PMID 34202088. PMC: 8304202. Archived from the original. . 
    - "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/)."
  3. ↑ Mario L. Marques-Piubelli, M.D., Carlos A. Torres-Cabala, M.D., Roberto N. Miranda, M.D.. Extranodal NK / T cell lymphoma, nasal type. Pathology Outlines. Last author update: 5 January 2021. Last staff update: 14 October 2021

Image sources
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