Lo Casto Antonio, Lorusso Francesco, Palizzolo Ettore, Sireci Federico, Dispenza Francesco, De Angelis Manfredi, Immordino Angelo, Gallina Salvatore, Bencivinni Francesco
Radiological Sciences Section, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, AOUP "Paolo Giaccone", Via del Vespro 129, 90127 Palermo, Italy.
Otorhinolaryngology Section, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, AOUP "Paolo Giaccone", Via del Vespro, 129, 90127 Palermo, Italy.
J Pers Med. 2024 Dec 9;14(12):1145. doi: 10.3390/jpm14121145.
Nasal and paranasal sinus masses can arise from a wide range of conditions, both benign and malignant, as well as congenital or acquired. Diagnosing these masses is often challenging, requiring a combination of nasal endoscopy, imaging studies, and histopathological analysis. Initial imaging frequently involves computed tomography or cone beam computed tomography (CBCT) to evaluate the bony anatomy of the nasal cavity and surrounding sinuses, while magnetic resonance imaging (MRI) is typically used for detailed assessment of soft tissues and to aid in differential diagnosis when the findings are inconclusive. This review examines nasal masses evaluated using CT, CBCT, and MRI, highlighting key imaging features that may assist in differential diagnosis. For non-neoplastic lesions, examples include conditions such as rhinoliths, inverted mesiodens, and septal mucoceles. Benign and borderline tumors discussed encompass lobular capillary hemangioma, inverted papilloma, septal osteoma, chondromesenchymal hamartoma, hemangioma, hemangiopericytoma, antrochoanal polyp, sinonasal angiofibroma, ossifying fibroma, and lipoma. Malignant tumors addressed in this review include adenocarcinoma, esthesioneuroblastoma, non-Hodgkin lymphoma, melanoma, and sarcoma. Diagnosing nasal lesions represent a significant challenge for otolaryngologists. Imaging characteristics of nasal masses play a crucial role in narrowing down differential diagnoses before surgery. However, nasal endoscopy combined with biopsy remains the definitive diagnostic approach.
鼻腔及鼻窦肿物可由多种情况引起,包括良性和恶性,以及先天性或后天性。诊断这些肿物往往具有挑战性,需要结合鼻内镜检查、影像学检查和组织病理学分析。初始影像学检查通常包括计算机断层扫描(CT)或锥形束计算机断层扫描(CBCT),以评估鼻腔及周围鼻窦的骨质结构,而磁共振成像(MRI)通常用于软组织的详细评估,并在检查结果不明确时辅助鉴别诊断。本文综述了使用CT、CBCT和MRI评估的鼻腔肿物,重点介绍了有助于鉴别诊断的关键影像学特征。对于非肿瘤性病变,例如鼻石、埋伏多生牙和鼻中隔黏液囊肿。所讨论的良性和交界性肿瘤包括小叶状毛细血管瘤、内翻性乳头状瘤、鼻中隔骨瘤、软骨间叶性错构瘤、血管瘤、血管外皮细胞瘤、上颌窦后鼻孔息肉、鼻窦血管纤维瘤、骨化性纤维瘤和脂肪瘤。本文综述的恶性肿瘤包括腺癌、嗅神经母细胞瘤、非霍奇金淋巴瘤、黑色素瘤和肉瘤。诊断鼻腔病变对耳鼻喉科医生来说是一项重大挑战。鼻腔肿物的影像学特征在手术前缩小鉴别诊断范围方面起着至关重要的作用。然而,鼻内镜检查结合活检仍然是明确的诊断方法。
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