Min Hyun Jin, Kim Kyung Soo
Department of Otorhinolaryngology, Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
J Craniofac Surg. 2017 Oct;28(7):1780-1783. doi: 10.1097/SCS.0000000000003748.
Recently, as the authors experienced nasal septal schwannoma and nasal septal neurofibroma with similar clinical symptoms but different endoscopic findings, the authors tried to review all the literatures previously reported on the "Nasal septal schwannoma and Nasal septal neurofibroma." The aim of this study is to thoroughly review previously reported patients with nasal septal schwannomas and neurofibromas and to describe similar and different features focusing on the differential diagnosis between the 2 entities. On the basis of our review, the authors made some important conclusions. First, benign peripheral nerve tumors originating from the nasal septum are uncommon. Especially, nasal septal neurofibroma is extremely rare that only 5 patients were reported. So, more clinical reports of benign peripheral nerve tumors are necessary to elucidate the differences between nasal septal schwannoma and nasal septal neurofibroma. Second, there are some similar features between nasal septal schwannoma and nasal septal neurofibroma such as clinical symptoms, endoscopic findings, and treatment strategy. However, since there seem to be some differences in nasal endoscopic findings, they may be helpful for the provisional diagnosis, and so more patients should be reported to verify that point. Third, image study, especially magnetic resonance imaging (MRI), is considered to be a useful tool for differential diagnosis of benign peripheral nerve tumors originating from the nasal septum. So, more clinical reports reporting MRI findings are needed to verify the differences. Last, because of distinctive histologic appearances of benign peripheral nerve tumors, it is usually not difficult to make the distinction between nasal septal schwannoma and nasal septal neurofibroma. However, immunohistochemical stains including S-100 protein, calretinin, CD 34, factor XIIIa, and CD56 are necessary when it is difficult to differentiate between 2 disease entities.
最近，由于作者遇到了临床症状相似但内镜检查结果不同的鼻中隔神经鞘瘤和鼻中隔神经纤维瘤，因此试图回顾此前所有关于“鼻中隔神经鞘瘤和鼻中隔神经纤维瘤”的文献报道。本研究的目的是全面回顾此前报道的鼻中隔神经鞘瘤和神经纤维瘤患者，并重点描述这两种病变在鉴别诊断方面的异同点。基于我们的回顾，作者得出了一些重要结论。首先，起源于鼻中隔的良性周围神经肿瘤并不常见。特别是，鼻中隔神经纤维瘤极为罕见，仅有5例报道。因此，需要更多关于良性周围神经肿瘤的临床报告来阐明鼻中隔神经鞘瘤和鼻中隔神经纤维瘤之间的差异。其次，鼻中隔神经鞘瘤和鼻中隔神经纤维瘤在临床症状、内镜检查结果及治疗策略等方面存在一些相似特征。然而，由于鼻内镜检查结果似乎存在一些差异，这些差异可能有助于初步诊断，因此需要报告更多患者以验证这一点。第三，影像学检查，尤其是磁共振成像（MRI），被认为是鉴别起源于鼻中隔的良性周围神经肿瘤的有用工具。因此，需要更多报告MRI检查结果的临床报告来验证其中的差异。最后，由于良性周围神经肿瘤具有独特的组织学表现，通常不难区分鼻中隔神经鞘瘤和鼻中隔神经纤维瘤。然而，当难以区分这两种疾病实体时，包括S-100蛋白、钙视网膜蛋白、CD 34、凝血因子XIIIa和CD56在内的免疫组化染色是必要的。
