Olfactory neuroblastoma (esthesioneuroblastoma)

Discussion:

The patient went on to have a resection. 

Histology

The sections show fragments of dense hyalinised collagen with prominent bundles of myelinated nerve fibers. There is extensive infiltration of the tissue fragments by a densely hypercellular tumor. This is composed of cells with small round, oval and angulated nuclei and a small amount of eosinophilic cytoplasm. These are dispersed in irregularly shaped anastomosing islands and cords. Frequent mitotic figures are noted. No necrosis is identified. Focal perineurial infiltration by tumor is noted. Tumor cells show strong cytoplasmic immunostaining for neuron-specific enolase (NSE) and synaptophysin.

Final diagnosis: esthesioneuroblastoma (olfactory neuroblastoma)

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