Sahu Kausalya K, Dosemane Deviprasad, Khadilkar Meera, Shetty Deeksha, Raminen Madhurya
Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, India.
Department of Otorhinolaryngology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, India.
Iran J Otorhinolaryngol. 2019 Nov;31(107):377-381. doi: 10.22038/ijorl.2019.29914.1972.
The sinonasal tract is an area that may be affected by various types of neoplastic lesions with more variety than what is encountered in other parts of the upper airway and food passage.
An elderly gentleman of 65 years complained of nose block on both sides for 3 months. On examination, he had firm polypoidal masses arising from the middle meatus and septum on both sides. Computed tomography scan of the sinuses revealed polypoidal mucosal thickening in bilateral sinuses with bilateral concha bullosa. The patient underwent functional endoscopic sinus surgery with the complete excision of the masses from the lateral wall and septum under general anesthesia. The results of the histopathological examination showed inflammatory changes in polypoidal tissues from the right maxillary, bilateral ethmoidal sinuses, and bilateral septal masses. The lesion in the left middle meatus showed the features of respiratory epithelial adenomatoid hamartoma (READ). The case had no evidence of residual or recurrent lesion during 6 months after the surgery.
The READ is a rare lesion observed in the sinonasal tract. It is a diagnostic dilemma for clinicians as it can be misdiagnosed as neoplastic lesions, such as inverted papilloma or adenocarcinoma, which would warrant radical surgery or sinonasal polyposis and be treated inadequately.
鼻窦区域可能受到各种类型肿瘤性病变的影响,其病变类型比上呼吸道和消化道其他部位更多样化。
一位65岁的老年男性主诉双侧鼻塞3个月。检查发现,双侧中鼻道和鼻中隔有质地硬的息肉样肿物。鼻窦计算机断层扫描显示双侧鼻窦有息肉样黏膜增厚及双侧泡状鼻甲。患者在全身麻醉下接受了功能性鼻内镜鼻窦手术,从侧壁和鼻中隔完整切除肿物。组织病理学检查结果显示,右侧上颌窦、双侧筛窦及双侧鼻中隔肿物的息肉样组织有炎症改变。左侧中鼻道病变表现为呼吸上皮腺样错构瘤(READ)。术后6个月,该病例无残留或复发病变迹象。
READ是鼻窦中观察到的一种罕见病变。它给临床医生带来诊断难题,因为它可能被误诊为肿瘤性病变,如内翻性乳头状瘤或腺癌,而这些病变可能需要根治性手术,或者被误诊为鼻息肉病而治疗不充分。