Lesion In Nasal Cavity Research Articles

Anesthetic Consideration of a Patient with McCune-Albright Syndrome: A Case Report

The McCune-Albright syndrome is rare disease diagnosed by the clinical triad, fibrous dysplasia, cafe-au lait skin pigmentations and endocrine hyperfunction. Those patients with bone issues could have various surgeries under general anesthesia. Airway abnormality and various endocrine abnormalities should be considered during general anesthesia for McCune-Albright syndrome patients. A 15-year-old male with McCune-Albright syndrome was admitted with complaint of right nasal obstruction originated from fibrous dysplasia. Endoscopic resection of nasal cavity lesion was scheduled under navigation system guidance. Difficult airway could be anticipated due to protrusion of maxilla and right nostril. Awake fiberoptic intubation was performed by spray-as-you-go technique. When an anesthesiologist expects to take care of the patient with the McCune-Albright syndrome, the most appropriate anesthetic induction and tracheal intubation technique should be selected, and multiple backup instruments such as supraglottic device, video laryngoscope and fiberoptic bronchoscopy should be prepared.

Uncommon Presentation of Non-Hodgkin's Lymphoma of Maxillary Sinus: A Case Report

Non-Hodgkin’s Lymphoma is a group of neoplasms that originate from the cells of the lymphoreticular system. In 40% of cases, it arises from extranodal sites. The nasal cavities and paranasal sinuses are rarely affected by primary Non hodgkin’s lymphoma. We report the case of a 60-year-old man admitted for Non-Hodgkin’s Lymphoma of maxillary sinus. CT scan demonstrated an extensive lesion destroying the medial and anterior walls. The patient received 6 cycles of the chemotherapy. The follow-up for the last 1 year was normal without recurrence. The difficulty encountered in the diagnosis of this clinicopathological entity owing to its radiological and clinical expression, particularly the evolution was discussed. Though rare, the signs and symptoms of the case suggest that Non hodgkin’s lymphoma should be considered in the differential diagnosis of nasal cavity lesions.

비중격에 발생한 호흡상피성 선종모양 과오종 1예

Hamartoma is non-neoplastic malformation of tissue characterized by an abnormal mixture of tissues. It can occur in any area of the body, especially in the lung, kidney, and intestine. Respiratory epithelial adenomatoid hamartoma (REAH) is an uncommon lesion in nasal cavity. It is important to differentiate REAH from other neoplasm, including adenocarcinoma and inverted papilloma because misdiagnosis can lead to aggressive surgery. We report a case of REAH in nasal septum diagnosed on histopathology. (J Clinical Otolaryngol 2014;25:236-239)

Syrian hamsters (Mesocricetus auratus) oronasally inoculated with a Nipah virus isolate from Bangladesh or Malaysia develop similar respiratory tract lesions.

Nipah virus is a paramyxovirus in the genus Henipavirus, which has caused outbreaks in humans in Malaysia, India, Singapore, and Bangladesh. Whereas the human cases in Malaysia were characterized mainly by neurological symptoms and a case fatality rate of ∼40%, cases in Bangladesh also exhibited respiratory disease and had a case fatality rate of ∼70%. Here, we compared the histopathologic changes in the respiratory tract of Syrian hamsters, a well-established small animal disease model for Nipah virus, inoculated oronasally with Nipah virus isolates from human cases in Malaysia and Bangladesh. The Nipah virus isolate from Bangladesh caused slightly more severe rhinitis and bronchointerstitial pneumonia 2 days after inoculation in Syrian hamsters. By day 4, differences in lesion severity could no longer be detected. Immunohistochemistry demonstrated Nipah virus antigen in the nasal cavity and pulmonary lesions; the amount of Nipah virus antigen present correlated with lesion severity. Immunohistochemistry indicated that both Nipah virus isolates exhibited endotheliotropism in small- and medium-caliber arteries and arterioles, but not in veins, in the lung. This correlated with the location of ephrin B2, the main receptor for Nipah virus, in the vasculature. In conclusion, Nipah virus isolates from outbreaks in Malaysia and Bangladesh caused a similar type and severity of respiratory tract lesions in Syrian hamsters, suggesting that the differences in human disease reported in the outbreaks in Malaysia and Bangladesh are unlikely to have been caused by intrinsic differences in these 2 virus isolates.

An observational study of nasal cavity toxicity in cancer patients treated with bevacizumab

Background: The nasal cavity is a vulnerable zone which may be damaged by vascular disorders. We systematically assessed the frequency and severity of nasal cavity alterations during bevacizumab treatment, to determine its clinical relevance and factors contributing to its onset.Patients and methods: We conducted a hospital-based cohort study in 47 consecutive patients with advanced cancers who were on treatment with chemotherapy and bevacizumab at different doses. All patients underwent otolaryngology (ENT) examination at the time of study initiation.Results: The mean number of cycles at first ENT examination was 16 (standard deviation = 14). A total of 45 patients (96%) showed nose mucosal lesions, of whom 30% had erosions and 62% had grade 1 – 2 epistaxis. One patient had septal perforation. Grades 1 – 4 sinus disorders were noted in 60%. There was a significant trend to a higher risk of grade ≥ 2 nasal events for bevacizumab doses > 7.5 mg/kg, concomitant taxane use and digital nasal self-manipulation.Conclusions: We found a high incidence of nasal cavity lesions in patients receiving bevacizumab, with evidence for a dose-related effect. Most cases were low grade and manageable without drug interruption, but severe toxicity may rarely occur. Oncologists should be aware of this unusual event.

Exudative inflammatory lesions in the nasal cavity in 28-day dose range finding studies in CByB6F1 mice and in 26-week carcinogenicity studies in Tg.rasH2 mice

Exudative inflammatory lesions in the nasal cavity in 28-day dose range finding studies in CByB6F1 mice and in 26-week carcinogenicity studies in Tg.rasH2 mice

Diagnostic imaging features of congenital nose and nasal cavity lesions.

A wide variety of congenital nasal lesions can present to clinical attention due to airway obstruction, the presence of a mass, and/or cosmetic deformity, including pyriform aperture stenosis, choanal atresia, nasopharyngeal atresia, arrhinia, congenital germline fusion cysts, cephaloceles, neuroglial heterotopia, nasolacrimal duct mucoceles, hamartomas, supernumerary nostril, and bifid nose. Computed tomography and magnetic resonance imaging, which are the main imaging modalities used to characterize these lesions, often serve complementary roles. Familiarity with embryology and anatomy is also essential for recognizing the diagnostic imaging findings related to congenital nasal lesions.

NON-MALIGNANT LESIONS;

Background: The presence of a mass in the nasal cavity and paranasal sinusesmay seem to be simple problem, but it is very difficult to differentiate clinically from potentiallymalignant tumors. Objective: To evaluate the clinical presentation and histopathologicalfeatures of the non malignant lesions of nasal cavity and paranasal sinuses. Study Design:Prospective descriptive study. Place and duration of study: Study was carried out indepartments of Paediatrics and ENT at Ghulam Muhammad Mahar Medical College HospitalSukkur from Jan 2009 to Dec 2012. Patients and Methods: The study included all cases of nonmalignantmasses of nasal cavity and paranasal sinuses, those attended the Paediatric & ENTdepartment and underwent the surgical intervention. One hundred twenty non-malignant caseswere enrolled for this study. A separate pro-forma was filled to record the cases biodata, history,clinical examination, investigations and histopathological diagnosis. All histopathologicallyproven malignant masses were excluded from the study. Results: Out of 120 cases 78 (65%)were males and 42 (35%) were females, with M:F ratio of 1.8:1. The age of presentation rangedfrom 8 years to 70 years and mean age was 26.3years. Sinonasal masses were found to bebilateral in 20 cases (16.67%), right sided in 65 (54.17%) and left sided in 35 (29.16%) cases. Themain presenting symptoms were nasal blockage 110 (91.66%), nasal discharge 102 (85%),sneezing 60 (50%), hypoinsomnia 36 (30%), epistaxis 24 (20%), headache 20 (18.33%) andmouth breathing 18 (15%) cases. Polyp was the most common lesion in 86 (71.66%) casesobserved in this study. The common histopathological diagnosis was simple inflammatory nasalpolyp in 48 (40%), allergic nasal polyps 30 (25%) and fibroepithelial polyp in 8 (6.7%), invertedpapilloma in 12 (10%), angiofibroma 6 (5%), capillary hemangioma 4 (3.34%) andrhinosporidiosis 4 (3.34%) cases. Conclusions: Sinonasal masses have various differentialdiagnoses and are still thought to be simple problem in our society. There is a need for earlyrecognition and referral to ENT surgeon and need histopathological examination of every massto confirm the diagnosis.

Clinico-pathological Study of Space Occupying Lesions of Nasal Cavity, Paranasal Sinuses and Nasopharynx.

A variety of non-neoplastic and neoplastic lesions of nasal cavity, paranasal sinuses and nasopharynx are commonly encountered in clinical practice. The aim of this study was to study clinical and histopathological profile of space occupying lesions of nasal cavity, paranasal sinuses and nasopharynx in a tertiary care hospital of Rajasthan over the period of January 2013 to January 2014. This was a prospective study of 147 cases (male 100, female 47; age group ranging from less than 1 y to 76 y) of space occupying lesions of nasal cavity, paranasal sinuses and nasopharynx over the period of 12 months (from January 2013 to January 2014). All tissues after fixation in 10% buffered formalin, processed and then stained with Hematoxylin & Eosin to study various histopathological patterns. These 147 cases were broadly categorized in two categories, one category as nasal and paranasal sinus masses and the other as nasopharyngeal masses with 91 and 56 cases, respectively. These lesions were common in second and third decades of life with male predominance. Among nasal and paranasal sinus masses, there were 67 (73.6%) non-neoplastic and 24 (26.4%) neoplastic lesions. Inflammatory polyps (89.5%) were the most common among the non-neoplastic masses; Inverted papilloma (45.46%) the most common among the benign neoplastic and squamous cell carcinoma (46.15%) was the commonest out of all malignant masses. Out of 56 nasopharyngeal masses, there were 53 (94.6%) non neoplastic and 3 (5.4%) neoplastic lesions. Majority of these i.e. 52 cases were of adenotonsillar hypertrophy. We concluded that complete clinical, radiological and histopathological correlation helps us to categorize these sinonasal lesions into various non-neoplastic and neoplastic types. But final histopathological examination provides a confirmatory diagnosis, although Immunohistochemistry is the final diagnostic method in few cases.

A Rare Case of Reparative Granuloma of Nasal Cavity

Giant cell reparative granuloma (GCRG) is a rare, benign tumour that mostly involves the maxilla and mandible. It is rare in the nasal cavity and paranasal sinuses. Here we report a case of GCRG of nasal cavity in 24-year-old man who came with unilateral nasal obstruction, epistaxis and proptosis. CT scan showed soft tissue hypodensity lesion of left nasal cavity. Endoscopic surgical excision and biopsy were done. The pathology was consistent with GCRG. There was no recurrence seen on follow-up for 2 years. A short literature review about diagnosis, clinical behavior, radiological findings and treatment of this tumor entity are given.

Recurrent Epistaxis and Nasal Congestion

Amaleteenagerpresentedwitha2-monthhistoryof recurrentepistaxis andnasal congestion.Nasal endoscopydemonstrateda2-cm friable mass in the left nasal cavity. A computed tomographic scan revealeda2.3-cmsoft-tissuedensity in the left nasal cavity (Figure, A) and amagnetic resonance imaging scan confirmedby this delineating a heterogeneously enhancing mass, without clear attachments to thenasal septum(Figure,B).Findings fromapositronemission tomographic scan were negative. The patient was brought to the operating room where he underwent nasal endoscopy with resection of the left nasal cavity lesion and adjacent septum. Histologic findings revealed a carcinomawithbasaloid features,composedofundifferentiatedcellswith hyperchromatic nuclei arranged in ribbons. Therewasbriskmitotic activity and areas of tumor necrosis (Figure, C). There was no perineural invasion, and themarginswere negative after resection. Results froma immunohistochemical stain forp16werepositive(Figure, D). The patient was disease free at his 6-month follow-up. What is your diagnosis? A

Clinicopathological evaluation of sinunasal neoplasm in a tertiary care hospital

Objective: Though sinu-nasal neoplasms comprise of a small percentage of head neck tumours, they areincreasing in incidence due to rapid industrialization and an increase in life expectancy. Further in many cases they present at an advanced stage and data from studies on them from eastern region of the country is limited, encouraging this study. The aim of this study to evaluate the clinical and demographic profile as well as the histological variation of sinunasal neoplasms and it relation with occupation and addiction. Methods: Design: Prospective study Setting: Tertiary government teaching hospital Participants: All patients presenting with neoplastic lesion in nasal cavity between December, 2009 to May, 2011 Results: Eighty two(82) patients-- 57 (69.51%) male and 25 (30.49%) female aged upto 80 years, were included, displaying male predominance and clustering in the fifth decade of life. Benign lesions (44 cases , 53.66%) were more common than the malignant lesions (33 cases , 40.24% ) and 5 cases (6.10%) were seen indeterminant for malignancy/low-grade malignant potential. Most common anatomical location was nasal cavity(57.32%) and farmers were mostly affected by sinonasal neoplasm (30%). Commonest clinical presentation was epistaxis (31.71%). Conclusion: Sinonasal neoplasms have wide range of possibilities. Commonly, patients present with nasal obstruction and epistaxis. Early diagnosis with the help of newer diagnostic modalities with prompt treatment is necessary for these patients. Histopathological diagnosis is necessary for any neoplastic lesion in nasal cavity. This will guide us for further management of these lesions Keywords: Paranasal sinus ; Neoplastic lesion ; Nasal obstruction ; Epistaxis ; Sinonasal neoplasm

Anaplastic lymphoma kinase-positive large cell lymphoma of the anterior skull base: Report of an unusual case and review of the literature

Background:Anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) is a rare peripheral T-cell lymphoma, accounting for approximately 3% of adult non-Hodgkin lymphomas (NHL). In this report we describe an unusual case of an ALK(+) ALCL, which presented as an aggressive mass involving upper nasal cavity and anterior skull base. The pathogenesis, histopathology with radiologic correlations, and management of this case are reviewed.Case Description:A 28-year-old Asian female presented with a 3-month history of nasal congestion culminating in epistaxis. Physical examination was notable for a tissue mass obstructing nasal cavity and the sphenoid sinus. Computed tomography (CT) and magnetic resonance (MR) imaging revealed a lesion primarily involving the upper nasal cavity extending intracranially through the cribriform plates into the anterior cranial fossa. Histologic and immunohistochemical analysis of the specimen obtained through a transnasal biopsy revealed an ALK(+) ALCL. The patient underwent two cycles of chemotherapy and focal radiation therapy, achieving minimal residual disease. The patient remained neurologically unchanged with stable minimal residual disease at the 1-year follow-up.Conclusions:To the best of our knowledge, this is the first case of an ALK(+) ALCL that presented as an aggressive upper nasal cavity and anterior skull base lesion. This case report highlights the importance of multi-modality approaches including preoperative imaging and tissue biopsy for definitive diagnosis.

An Esthesioneuroblastoma Mimicking a Fibro‐osseous Lesion

Objective: 1) Present the unique radiology and pathology of a coarsely calcified pediatric esthesioneuroblastoma (ONB) that was incorrectly suggested preoperatively to be a fibro-osseous tumor. 2) Review the clinical presentation, radiographical and pathological findings, treatment, and prognosis of ONBs. Method: The PubMed database was searched from 1958 to 2011, limited to the English language, using keywords esthesioneuroblastoma, radiology, and calcification. Results: Esthesioneuroblastomas present with nasal obstruction, pain, hyposmia and epistaxis. Imaging shows a destructive, soft tissue mass without calcifications. Treatment includes surgery, radiation and chemotherapy. Ten year survival is significantly decreased in Hyams high-grade pathological tumors. We present a 12 year-old female with Kadish C and Dulguerov-Calcaterra T3N0M0 esthesioneuroblastoma that on CT and MRI revealed a coarsely calcified 3.8 × 3.5 × 4.1 cm mass involving the right nasal vault and paranasal sinuses. Due to the extensive calcifications, it was incorrectly suggested preoperatively to be a fibro-osseous lesion. She underwent endoscopic-assisted resection with postoperative radiation and is disease-free 9 months post-treatment. Conclusion: Our case highlights a unique radiographic presentation of esthesioneuroblastoma and emphasizes that this uncommon neuroectodermal malignant tumor always be in the differential for unilateral nasal cavity lesions. Optimal treatment requires a multidisciplinary approach and long-term clinical surveillance is essential.

Rising Incidence of Mucosal Melanoma of the Head and Neck in the United States

Background. While it is established that the incidence of cutaneous melanoma has risen over time in the United States, the incidence trend for mucosal melanoma of the head and neck (MMHN) is unknown. Methods. We used the Surveillance, Epidemiology, and End Results (SEER) database to determine incidence trends for MMHN from 1987 to 2009 in the United States. We determined annual percent change (APC) by weighted least squares and joinpoint regression analysis. Results. MMHN incidence increased from 1987 to 2009 (APC 2.4%; P < 0.01). Nasal cavity lesions increased in incidence (APC 2.7%; P < 0.01) over this duration, while the incidence of non-nasal cavity lesions remained stable. The highest rate of increase was in white females ages 55 to 84 (APC 5.1%; P = 0.01). Conclusions. The incidence of MMHN in the United States has been rising since 1987. This trend is driven primarily by increased incidence of nasal cavity melanomas.

Nasal Natural Killer/T-Cell Lymphoma: A Report of 7 Cases

We report the clinical course of 7 subjects with nasal extranodal natural killer/T-cell (NK/T) lymphoma (ENKL—6 men and 1 woman, aged 34-71 years—) treated between 2007 and 2010. Most had necrotic nasal cavity lesions that prevented an accurate pathological diagnosis. Definitive pathological diagnoses were obtained from 1 to 12 months after symptom onset (mean: 7.0±4.2 months). The mean time for taking biopsies was 2.6±1.7 months, and specimens required for diagnoses numbered 8.3±7.6. Subjects suspected of malignant lymphoma at initial biopsy required less time and fewer specimens for definitive diagnosis than those with a diagnosis suspected for other than malignant lymphoma. Based on Ann Arbor staging classification, 4 of the 7 were classified as stage I, 2 as stage II, and 1 as stage IV. One each in stages I and II attained remission, 2 in stage I are undergoing treatment, and one each in stages I and IV died during treatment. Early diagnosis is thus a critical factor in determining the prognosis of those with extranodal NK/T lymphoma. Our results suggest the importance of otolaryngologists to biopsy non necrotic tissues and to ensure clinical evaluation enabling prompt pathological diagnosis.

Study of Histopathological Changes in Primary Atrophic Rhinitis

Primary atrophic rhinitis is a progressive chronic nasal disease and histopathologically characterized by squamous metaplasia and two characteristic types of vascular involvement (type I and type II). Despite its chronicity and squamous transformation, nothing is known about the occurrence of malignancy in atrophic rhinitis. The present work was undertaken to study the histopathological characteristics in primary atrophic rhinitis and identify whether it has any association with malignant transformation. Nasal biopsies obtained from 90 patients diagnosed as primary atrophic rhinitis were studied. Squamous metaplasia was noted in 89% of patients, and type I and type II vascular involvement were seen in 67% and 33% of patients, respectively. This preliminary report suggests that there is no association between atrophic rhinitis and precancerous lesions of nasal cavity despite squamous metaplasia and confirms the presence of two types of vascular changes in the disease which is helpful to decide the treatment modality.

Nasal epithelial lesions in F344 rats following a 90-day inhalation exposure to naphthalene

Naphthalene (NA) was shown to be carcinogenic, causing respiratory epithelial adenoma in the nasal cavity of male F344 rats and olfactory epithelial neuroblastoma in female F344 rats at exposure concentrations of 10–60 ppm in a 2-year inhalation study conducted by the National Toxicology Program. To explore the exposure-response relationship and threshold for nasal epithelial effects in F344 rats, a 90-day (6 h/d, 5 d/wk) inhalation study was conducted at 0, 0.1, 1, 10 and 30 ppm NA vapor. Group size for nasal cavity histopathology was 10/sex with an additional 10/sex evaluated 4 wk post-exposure. NA exposure concentrations were measured by GC/MS, and aerosol testing verified that solid NA particles were not present. There were no NA exposure-related clinical observations and mild decreases in body weight (<10%) and food/water consumption were observed primarily in the 30 ppm rats. Rat heads were cross-sectioned at six levels for microscopic examination. There were no nasal cavity lesions related to NA exposure in rats of the 0.1 ppm group. Minimal hyperplasia was observed in the transitional/respiratory epithelium of rats exposed to 1 ppm. Mild hyperplasia and minimal squamous metaplasia were observed in the respiratory epithelium of rats exposed to 10 or 30 ppm. Lesions in the olfactory epithelium were observed only in rats of the 10 or 30 ppm groups and consisted of degeneration, necrosis, areas of re-epithelialization and basal cell hyperplasia. There was remarkable recovery of effects after 4 weeks, but residual olfactory epithelial degeneration and basal cell hyperplasia were still evident.

Respiratory Epithelial Adenomatoid Hamartoma Originating from Nasal Septum

Respiratory epithelial adenomatoid hamartoma (REAH) is a rare benign lesion in nasal cavity. We report two cases of REAH of the nasal cavity arising from nasal septum. The etiology of REAH is unknown although inflammation may induce gland proliferation observed in hamartomas. One of our cases was associated with nasal polyposis. REAH is a self-limiting disease, so it is important to differentiate REAH from other pathologic process, including inverted papilloma and low-grade adenocarcinoma. The treatment of choice is complete excision through a conservative approach.

Histopathological Study of Lesions of Nose and Paranasal Sinuses

(1) To study the incidence of benign and malignant lesions of nose and paranasal sinuses (PNS). (2) To study various lesions in reference to sex differences and symptomatology. (3) To compare the findings of the study with other authors. The study was conducted over a period of 7years both retrospectively and prospectively. The formalin fixed specimens were received with complete clinical and radiological features. Routine gross examination and required number of sections were taken and stained with hematoxylin and eosin. Periodic acid Schiffs and reticulin stains were used wherever necessary. The incidence of lesions in nasal cavity (NC) and PNS was 16.71 cases per year, non-neoplastic lesions constituted 86% of these cases and their incidence was 14.42% and neoplastic lesions constituted 12%. All the cases were carefully examined histopathologically and it was found that the region was affected by variety of lesions. Among 117 cases, 101 were non-neoplastic and 16 were neoplastic. The commonest site was NC, followed by PNS. They occur commonly in second and third decades with predominance in males. Amongst the non-inflammatory lesion, nasal polyp is the commonest lesion followed by rhinoscleroma and rhinosporidiosis. The common age group is second and third decades, with male predominance. Amongst benign neoplastic lesions capillary haemangioma was common followed by inverted papilloma. The common age group is second and third decades, with male predominance. Malignant lesions were comparatively less to that of benign lesions.