Deotale Sanjay, Wankhade Rashmi, Dawande Pratibha, Bankar Nandkishor
Pathology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND.
Microbiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Apr 30;16(4):e59341. doi: 10.7759/cureus.59341. eCollection 2024 Apr.
The uncommon, non-hereditary congenital abnormalities known as nasal glial heterotopias (NGH) are composed of heterotopic neuroglial tissue. Typically, NGH manifests in infancy, but occasionally it can also be seen in older children and adults. To rule out intracranial extension, magnetic resonance imaging (MRI) and computed tomography (CT) scans should be performed. Numerous cases have been documented where NGH was mistakenly identified as encephaloceles, teratomas, dermoid cysts, capillary haemangiomas, and even desmoids. A proper clinical, sonological, and even CT and MRI evaluation can lead to a near-final diagnosis; nonetheless, surgical excision and histological confirmation are the gold standards. We report a rare case of a firm, subcutaneous, non-tender, non-reducible midline 2 x 2 x 1 cm swelling with bluish-red skin near the root of the nose that was not affected by posture or pressure. Encephalocele, NGH, and dermoid were the differential diagnoses made based on the oedema found on CT and MRI scans. Histopathology provided a conclusive NGH diagnosis. The instance illustrates the significance of histology as the gold standard for NGH diagnosis.
鼻神经胶质异位(NGH)是一种罕见的非遗传性先天性异常,由异位神经胶质组织构成。通常,NGH在婴儿期出现,但偶尔也可见于大龄儿童和成人。为排除颅内扩展,应进行磁共振成像(MRI)和计算机断层扫描(CT)。已有大量病例记录显示,NGH曾被误诊为脑膨出、畸胎瘤、皮样囊肿、毛细血管瘤,甚至硬纤维瘤。恰当的临床、超声检查,甚至CT和MRI评估可得出近乎最终的诊断;尽管如此,手术切除和组织学确认仍是金标准。我们报告一例罕见病例,患者在鼻根部附近有一个质地坚硬、皮下、无压痛、不可复位的中线2×2×1 cm肿物,皮肤呈蓝红色,不受体位或压力影响。根据CT和MRI扫描发现的水肿情况,鉴别诊断考虑为脑膨出、NGH和皮样囊肿。组织病理学检查确诊为NGH。该病例说明了组织学作为NGH诊断金标准的重要性。