Presentation
Nasal obstruction.
Patient Data
There is a heterogeneous, brightly enhancing soft tissue mass centered in the left maxillary sinus extending through the maxillary ostium into the middle meatus of the nasal cavity . The ostium is widened and the ostiomeatal complex is occluded. There is no evidence of diffusion restriction. There is no evidence of bone destruction or extension of abnormality into the left infratemporal fossa or left orbit. There is no convincing evidence perineural spread. There is fluid in both maxillary sinuses (left greater than right) both sphenoid sinuses, left frontal sinus, and in the ethmoid air cells.
Limited images of the brain demonstrate no intracranial abnormality. In particular, no extra-axial collection or signal abnormality of the brain parenchyma is demonstrated. Foci of hyperintensity on axial T1 weighted sequences over the inferior frontal lobe have no correlate on T1 sagittal sequences, and are felt to represent artefact.
Case Discussion
The patient had the left nasal polyp/lesion biopsied.
Histology
MICROSCOPIC DESCRIPTION: Sections show non keratinizing stratified squamous mucosa with underlying stroma. There is mild spongiosis, scattered intraepithelial neutrophils and reactive atypia. The stroma contains a mixed acute and chronic inflammatory cell infiltrate. There is no evidence of dysplasia or malignancy. A PAS stain is negative for fungal micro-organisms.
FINAL DIAGNOSIS: Fibroepithelial polyp with acute inflammation.
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