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一种炎性息肉样良性鼻窦肿物病变——呼吸上皮腺瘤样错构瘤:病例报告

An Inflammatory Polyp-Like Benign Sinonasal Mass Lesion - Respiratory Epithelial Adenomatoid Hamartoma: A Case Report.

作者信息

Sudheer Kumar Marlapudi, Bishnoi Tapasya, Sahu Pankaj Kumar, Kumar Sanjay, Gleamine Selvam, Km Biradar, Singh Abhishek

机构信息

Department of ENT-HNS, Command Hospital Airforce, Bangalore, India.

Department of Pathology, Command Hospital Airforce, Bangalore, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3999-4002. doi: 10.1007/s12070-023-04012-9. Epub 2023 Jun 30.


DOI:10.1007/s12070-023-04012-9
PMID:37974750
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10646055/
Abstract

Respiratory epithelial adenomatoid hamartoma (REAH) is an uncommon, benign glandular proliferation that arises from the surface epithelium of the nasal cavity and paranasal sinuses. Here we report a case, wherein a 62-year male from northern Kerala presented with bilateral nasal obstruction, loss of sense of smell, and bilateral nasal discharge. On examination, a polypoidal lesion was observed in the left nasal cavity, filling the entire left middle meatus. Diagnostic nasal endoscopy revealed a multilobulated polypoidal mass in the left nasal cavity extending posteriorly into the nasopharynx and causing partial occlusion of the (R) choana. Computerized tomography(CT) imaging was suggestive of a mass in (L) nasal cavity extending from the frontal sinus to the inferior turbinate and posteriorly extending into the nasopharynx. The patient underwent Endoscopic endonasal excision of the (L)nasal mass and intraoperatively the mass was seen to arise from the septum in the (L) nasal cavity posteriorly. Histopathological examination confirmed the diagnosis of REAH. This case report emphasizes the significance of including REAH in the differential diagnosis of sinonasal masses as it simulates other inflammatory disorders. Appropriate diagnosis by biopsy prevents unnecessary aggressive surgery as this benign condition mimics malignant lesions. More research is needed to understand the etiopathogenesis and diagnostic usefulness of immunohistological staining in REAH.

摘要

呼吸道上皮腺样错构瘤(REAH)是一种罕见的良性腺体增生,起源于鼻腔和鼻窦的表面上皮。在此我们报告一例,一名来自喀拉拉邦北部的62岁男性,出现双侧鼻塞、嗅觉丧失和双侧鼻分泌物增多。检查时,在左侧鼻腔观察到一个息肉样病变,占据整个左侧中鼻道。诊断性鼻内镜检查显示左侧鼻腔有一个多叶状息肉样肿物,向后延伸至鼻咽部,导致右侧后鼻孔部分阻塞。计算机断层扫描(CT)成像提示左侧鼻腔有一肿物,从额窦延伸至下鼻甲,并向后延伸至鼻咽部。患者接受了左侧鼻腔肿物的鼻内镜下切除,术中可见肿物起源于左侧鼻腔后部的鼻中隔。组织病理学检查确诊为REAH。本病例报告强调了在鼻窦肿物的鉴别诊断中纳入REAH的重要性,因为它可模拟其他炎症性疾病。通过活检进行恰当诊断可避免不必要的激进手术,因为这种良性疾病可模仿恶性病变。需要更多研究来了解REAH的病因发病机制以及免疫组织化学染色在其中的诊断价值。

相似文献

[1]
An Inflammatory Polyp-Like Benign Sinonasal Mass Lesion - Respiratory Epithelial Adenomatoid Hamartoma: A Case Report.

Indian J Otolaryngol Head Neck Surg. 2023-12

[2]
Respiratory Epithelial Adenomatoid Hamartoma in a Young Female: A Diagnostic Dilemma.

Cureus. 2023-10-4

[3]
Respiratory Epithelial Adenomatoid Hamartoma (REAH) in the Olfactory Cleft: Often Masked by Bilateral Nasal Polyps.

Indian J Otolaryngol Head Neck Surg. 2019-11

[4]
. Respiratory epithelial adenomatoid hamartoma - typical but underdiagnosed pathology of nasal cavity and sinuses.

Cas Lek Cesk. 2019

[5]
Is Respiratory Epithelial Adenomatoid Hamartoma Related to Central Compartment Atopic Disease?

Am J Rhinol Allergy. 2020-9

[6]
Respiratory epithelial adenomatoid hamartoma: A rare differential diagnosis of sinonasal mass.

Rare Tumors. 2024-5-14

[7]
Respiratory epithelial adenomatoid hamartoma associated with inflammatory nasal polyposis: a case report.

Kulak Burun Bogaz Ihtis Derg. 2012

[8]
A case report of adolescent respiratory epithelial adenomatoid hamartoma.

Ear Nose Throat J. 2025-3

[9]
Endoscopic endonasal resection of respiratory epithelial adenomatoid hamartomas of the sinonasal tract.

Int Forum Allergy Rhinol. 2014-12

[10]
Respiratory epithelial adenomatoid hamartomas of the sinonasal tract: A histopathological analysis of 50 patients.

Pathol Int. 2022-11

本文引用的文献

[1]
Respiratory epithelial adenomatoid hamartoma: a diagnostic challenge in sinonasal lesions.

BMJ Case Rep. 2019-8-4

[2]
The presentation and clinical significance of sinonasal respiratory epithelial adenomatoid hamartoma (REAH).

Int Forum Allergy Rhinol. 2012-10-4

[3]
Respiratory epithelial adenomatoid hamartomas.

Laryngoscope. 2011-10-17

[4]
Respiratory epithelial adenomatoid hamartoma: a review.

Head Neck Pathol. 2008-9

[5]
Low-grade sinonasal adenocarcinomas: the association with and distinction from respiratory epithelial adenomatoid hamartomas and other glandular lesions.

Am J Surg Pathol. 2009-3

[6]
Frontal sinus hamartomas.

Am J Otolaryngol. 2005

[7]
Respiratory epithelial adenomatoid hamartoma in the nasal cavity.

Acta Otolaryngol. 2002-6

[8]
Respiratory epithelial adenomatoid hamartomas of the sinonasal tract and nasopharynx: a clinicopathologic study of 31 cases.

Ann Otol Rhinol Laryngol. 1995-8

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