Jeong Hui-Jeong, Roh Jin, Lee Bong-Jae, Cho Kyung-Ja
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43 gil, Songpa-gu, Seoul, 05505, South Korea.
Department of Otorhinolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Head Neck Pathol. 2018 Mar;12(1):131-135. doi: 10.1007/s12105-017-0832-z. Epub 2017 Jun 21.
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.
鼻腔和鼻窦覆盖着起源于外胚层的纤毛呼吸黏膜,即所谓的施奈德氏上皮,它可引发不同类型的鼻窦癌。一名42岁女性,3年前有鼻息肉切除术史,现出现鼻塞和鼻漏。经影像学检查发现她左侧鼻腔、左上颌窦和筛窦有一个乳头状肿物。她在诊断为嗜酸细胞乳头状瘤后接受了鼻内切除术。切除标本显示上皮细胞呈乳头状或内翻状结构的旺盛浸润性生长。肿瘤细胞非常温和,呈圆形至多边形,核质比低,嗜酸细胞质丰富,核均匀,核仁不明显,有丝分裂少见。总体特征与最近一篇关于低级别乳头状施奈德氏癌的报道一致。主要鉴别诊断为施奈德氏乳头状瘤,认识到这种新实体对其正确治疗很重要。