WSI22-141

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Request type Study

Subspecialty Head and Neck

Set ENT Pathology

Topic Sinonasal and Nasopharynx

Presenter Sadow, Peter M.,MD, PhD

Date and time Saturday, October 1, 2022 12:00 PM

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Case	Clinical history	Requester	Diagnosis
Case	Clinical history	Requester	Diagnosis
Case 1	30 year old with multiple years of recurrent sinus infections and asymmetric breathing	Si787	Chronic rhinosinusitis
Case 2	61 year old male with chronic sinusitis • nasal obstruction • and left maxillary inverted papilloma; here • left sinus contents	Si787	Schneiderian papilloma • inverted type • extensive. There is no evidence of dysplasia
Case 3	75 year old male with left nasal tumor	Si787	Sinonasal glomangiopericytoma (1.3 cm) +SMA • + nuclear B catenin • - kerative • - CD34 • -S100
Case 4	42 year old male with left nasal polyp. Rule out lymphoma	Si787	c/w aneurysmal bone cyst
Case 5	50 year old female with chronic sinusitis	Si787	Chronic rhinosinusitis with central nervous tissue
Case 6	66 year old male with h/of nasal polyp	Si787	Respiratory epithelial adenomatoid hamartoma
Case 7	60 year old male with nasal polyps • sinusitis and left septal lesion	Si787	Respiratory epithelial adenomatoid hamartoma
Case 8	74 year old female with history of multiple lesions of this type and now with left nasal septum mass	Si787	Xanthogranuloma (0.7 cm) +CD163 • + CD68 • - ALK-1 • CD1 • CD23 • CD35
Case 9	15 year old male with nasopharyngeal mass	Si787	Juvenile nasopharyngeal angiofibroma (4.0 cm)
Case 10	62 year old female with vague history of fibrous dysplasia (not documented at MGH) with prior left sinus biopsy showing polypoid chronic rhinosinusitis. She now has had new onset ofleft supraorbital pain and pressue for 1.5 months.	Si787	Meningioma • infiltrating sinus tissue and bone
Case 11	36 year old male with right sinonasal mass with worsening nasal obstructive symptom with a one time episode of severe nose bleed almost one year prior. CT shows a 3.4 cm mass centered along the sphenopalatine foramen	Si787	Juvenile nasopharyngeal angiofibroma
Case 12	59 year old male • endosinus drainage of abscess; orbital abscess	Si787	Schneiderian papilloma • inverted type.
Case 13	39 year old male with 3 mm lesion superior aspect of inferior turbinate	Si787	Low grade glandular neoplasm most consistent with an atypical pleomorphic adenoma • sinonasal type
Case 14	72 year old male with intranasal mass • previously biopsied outside • with unusual features. Thought to be benign.	Si787	Salivary-type carcinoma • low to intermediate grade • with divergent differentiation • arising in association with a hamartoma.
Case 15	40 year old male ith trans-septal nasal mass	Si787	Glomangiopericytoma with surface ulceration and contact ulcer/pyogenic granuloma
Case 16	49 year old male with a slow-growing • large mass within the maxillary sinus extending to the temporal area as well as the masseter muscles and posteriorly into the cavernous sinus	Si787	Low grade osteosarcoma
Case 17	20 year old male with sudden onset of anosmia and dysgensia	Si787	Olfactory neuroblastoma (subtype is esthesioneuroepithelioma)
Case 18	20 year old male with sudden onset of anosmia and dysgensia	Si787	Olfactory neuroblastoma (subtype is esthesioneuroepithelioma)
Case 19	47 year old female with obstructive nasal mass. Sent with R/O lymhoma	Si787	Nasopharnygeal carcinoma
Case 20	70 year old male with epistaxis and recurrent left-sided nasal lesion first biopsied 3 years prior	Si787	Schneiderian papilloma • oncocytic type
Case 21	48 year old male with diplopia and right proptosis. CT - large • enhancing mass emanating from superior right nasal region and ethmoid air cells up to 4.2 cm	Si787	Sinonasal undifferentiated carcinoma • infiltrating bone • with LVI
Case 22	53 year old male with h/o recurrent respiratory infectious and sinusitis	Si787	A. Schneiderian papilloma • inverted type with melanosis. B. Melanosis
Case 23	48 year old male with recurring intranasal lesion	Si787	Schneiderian papilloma • exophytic type (HPV-related)
Case 24	53 year old male with h/o of renal cell carcinoma (clear cell type • grade 3/4) 3 yrs prior who prsents with a lesion of the paranasal sinuses	Si787	Metastatic clear cell renal cell carcinoma to sinus mucosa
Case 25	47 year old male with congestion of nasal passages and sinuses	Si787	Chronic rhinosinusitis with numerous non-caseating granulomas c/w sarcoidosis. GMS & PAS/D are negative
Case 26	30 year old male with right maxillary sinus problem presenting with loosening of teeth in right upper maxilla over he course of one year	Si787	Inflammatory fibroblastic sarcoma • low grade (1 of 3) • 4.0 cm. MITS 11:10 hpf • - ALK-1 • SMA +focal keratin
Case 27	46 year old female with septal deviation and chronic rhinosinusitis	Si787	Nasal mucosal hamartoma with apocrine and papillary change (0.2 cm) in setting of chronic rhinosinusitis
Case 28	55 year old female with chronic sinusitis	Si787	Schneiderian papilloma • oncocytic type
Case 29	15 year old female with recurring rhinosinusitis	Si787	Allergic fungal rhinosinusitis with eosinophils and allergic mucin
Case 30	72 year old female with nasal cavity mass • biopsy	Si787	High grade carcinoma • NOS
Case 31	21 day old male with nasal congestion and intranasal mass	Si787	Nasal glial heterotopia (nasal glioma)
Case 32	59 year old female with chronic rhinosinusitis and large antral choanal polyp on the left.	Si787	Polypoid sinonasal mucinous hamartoma
Case 33	86 year old with left intranasal lesion	Si787	Basal cell adenoma • tubulotrabecular type (aggregating to 5.0 cm)
Case 34	55 year old male ith 2 year h/o epiphora with imaging revealing a lacrimal sac tumor with boy erosion and invading into the left orbit • nasal cavity and maxillary sinus	Si787	Adenoid cystic carcinoma • solid and cribriform types
Case 35	65 year old male presents with opacification of right sinus	Si787	Sinonasal adenocarcinoma • low grade • NOS • with features of intestinal-type • nondiagnostic of
Case 36	53 year old female with left nasal lesion	Si787	Oncocytoma with cystic and papillary change (0.7 cm)
Case 37	48 year old male with recurrent lesion of the nasal septum	Si787	Myoepithelial-rich low grade salivary gland neoplasm. 1. Recurrent. 2. Pleomorphic adenoma with elevated risk of recurrence/aggressive behavior as no gross evidence of disease
Case 38	29 year old male with h/o multiorgan failure with nasal necrosis	Si787	Infiltrative fungal hyphae c/w aspergillus species
Case 39	60 year old female with chronic rhinosinusitis with ethmoid opacification	Si787	Aspergilloma with polarizable calcium oxalate crystals
Case 40	33 year old female with sinonasal lesion	Si787	Sinonasal small cell carcinoma
Case 41	34 year old female with nasal mass	Si787	Osteoblastoma
Case 42	62 year old physician with left nasal mass	Si787	Low grade • benign-appearing fascicular spindle cell neoplasm suggestive of myepithelial. Focal p63 • focal S100 • - keratins • - SMA
Case 43	88 year old female with lesion in right ala ofnose	Si787	Sebaceous cell carcinoma (1.7 cm) + PN1
Case 44	50 year old male with h/o sinonasal tumor	Si787	Invasive Schneiderian carcinoma with carcinoma in situ
Case 45	64 year old female with h/o sinusitis; now with bony mass •  ? fibro-osseous lesion	Si787	Sinonasal hamartoma
Case 46	54 year old Moroccan male with several years history of intermittent nose bleeds with 4 cm mass in nasopharynx of CT left nasal blockage X 3 months	Si787	Nasopharyngeal carcinoma • non-keratinizing undifferentiated type. EBER +
Case 47	73 year old male skin of nose	Si787	Rhinophyoma
Case 48	50 year old male with a nasopharyngeal mass	Si787	Nasopharyngeal carcinoma • non-keratinizing undifferentiated type. EBER +
Case 49	40 year old male presents with increasing chronic left nasal and sinus congestion with increasing hx of nose bleeds and headache	Si787	Sinonasal undifferentiated carcinoma • HPV16+
Case 50	10 year old male with nasal mass	Si787	Dermoid cyst
Case 51	49 year old female with bilateral skull-based tumor and cranial nerve palsy	Si787	Adenoid cystic carcinoma • solid and cribriform types + PN1
Case 52	23 year old male	Si787	Sinonasal low grade adenocarcinoma • non-intestinal type
Case 53	9 year old male with nasopharyngeal tumor	Si787	Nasopharyngeal carcinoma • non-keratinizing • undifferentiated type
Case 54	33 year old female	Si787	Consistent with ecthyma gangrenosum dur to Pseudomonas aeruginosa (Gram negative rods on Brown-Hopps)
Case 55	71 year old female	Si787	Poorly differentiated neuroendocrine carcinoma
Case 56	63 year old female	Si787	Schneiderian papilloma • oncocytic type
Case 57	82 year old female	Si787	Atpical pleomorphic adenoma (5.7 cm)
Case 58	46 year old male	Si787	Plurihormonal pituitary adenoma • infiltrating sinus mucosa
Case 59	40 year old male	Si787	Spindle cell squamous cell carcinoma
Case 60	29 year old woman with a history of unilateral conductive hearing loss and unspecified contralateral hearing loss • also with a history of rhinitis • chronic eustachian tube dysfunction and a nasopharyngeal mass that clinically looks like skin.	Pms36	Hairy polyp