scholarly journals Benign Sinonasal Masses: A Clinicopathological and Radiological Profile

2014 ◽  
Vol 11 (1) ◽  
pp. 4-8 ◽  
Author(s):  
A Nepal ◽  
ST Chettri ◽  
RR Joshi ◽  
S Karki
Keyword(s):  
Paranasal Sinus ◽  
Nasal Polyps ◽  
Histopathological Examination ◽  
Treatment Plan ◽  
Final Diagnosis ◽  
Benign Tumors ◽  
Ossifying Fibroma ◽  
Fungal Sinusitis ◽  
Imaging Studies ◽  
Inverted Papillomas

Background Benign nasal and paranasal sinus masses are commonly encountered in clinical practice. Though benign, certain nasal polyps, fungal sinusitis, hemangiomas and fibro-osseous tumors can present with locally destructive features and deformities, mimicking malignancies at once. Objective This study was carried out to recognize the great variety of benign nasal lesions and their frequency in our region. Methods A retrospective chart analysis of cases presenting as mass in nose and paranasal sinus that underwent surgery over three years duration at our institute was done. A provisional diagnosis was made after clinical assessment and radiological investigations, but the final diagnosis was established after histopathological examination. Results A total 331 cases presented as masses in nose and paranasal sinus presented during the period. The clinicopathological examination aided by endoscopic and imaging studies revealed the non neoplastic benign masses in 293 and neoplastic masses in 38. Polyps were the commonest lesions constituting 70% cases followed by rhinosporidiosis in 10%. Fungal sinusitis, squamous papillomas, hemangiomas and inverted papillomas were found to be in order of 4.5%, 4%, 3.5% and 3% respectively. Rare cases like “rhino-oto-cereberal” form of mucormycosis, angiomyoma, and psammomatoid ossifying fibroma were also observed in the study. Conclusion Most of the nasal polyps/fungal sinusitis can be diagnosed clinically. However many a times Computer tomography (CT) scan and biopsy are necessary to differentiate them from each other and treatment plan. Certain benign tumors have high potential for malignant transformation while others can present with locally destructive features and deformities. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11015 Kathmandu University Medical Journal Vol.11(1) 2013: 4-8

scholarly journals Solitary Schwannoma on the Hypothenar Region of the Hand: A Literature Review

2020 ◽  
Vol 5 (10) ◽  
pp. 449-452
Author(s):  
Kastanis G ◽  
Kapsetakis P ◽  
Magarakis G ◽  
Bachlitzanaki M ◽  
Christoforidis C ◽  
...  
Keyword(s):  
Literature Review ◽  
Clinical Diagnosis ◽  
Peripheral Nerves ◽  
Histopathological Examination ◽  
Final Diagnosis ◽  
Benign Tumors ◽  
Rare Manifestation ◽  
Histopathological Evidence ◽  
Volar Surface

Schwannomas or neurilemmomas are the most common benign tumors of the neural sheaths of the peripheral nerves. Incidence of these tumors in the hand accounts to 0.8-2%. The majority of them appear as an isolated grown mass along the route of the nerves. Peripheral nerves benign tumors present many difficulties concerning the clinical diagnosis and only histopathological evidence provides the final diagnosis. In this case study, we present a 45 year old man with a grown asymptomatic mass on the volar surface of right hand (hypothenar) remained for two years and impinging the skin of the hand only the last months. Initial MRI results diagnosed the mass as gaglion cyst. Histopathological examination revealed a schwannoma. We present this case as a rare manifestation of a schwannoma in hypothenar area of the hand. A literature review of diagnoses and therapeutic management is also presented.

scholarly journals Nasomaxillary swellings: our experience at tertiary care hospital

2021 ◽  
Vol 7 (3) ◽  
pp. 469
Author(s):  
Mukesh Rawat ◽  
Archana Lall ◽  
Kavita Sachdeva
Keyword(s):  
Tertiary Care Hospital ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Final Diagnosis ◽  
Inverted Papilloma ◽  
Nasal Endoscopy ◽  
Common Symptom ◽  
Fungal Sinusitis ◽  
Care Hospital ◽  
Malignant Lesions

<p class="abstract"><strong>Background:  </strong>A wide spectrum of lesions may present as nasomaxillary swellings ranges from benign to malignant lesions including fungal sinusitis and fibro vascular lesions example: JNA (Juvenile nasopharyngeal angiofibroma) and Inverted papilloma. Many Pathologies ranging from benign to malignant tumors may mimic a simple Nasomaxillary mass. It is diagnostic challenge to determine pathology behind it. A detailed clinical evaluation with nasal endoscopy and relevant pre-operative investigations including radiological imaging and histopathological examination is essential to reach up to final diagnosis. The aim of the study was to do clinicopathological evaluation of patients presenting with nasomaxillary swelling and correlation of clinical, radiological and Histopathological findings.</p><p class="abstract"><strong>Methods: </strong>This was a prospective observational study on 50 nasomaxillary swelling patients who are presented in the Department of ENT and Head and Neck Surgery of N.S.C.B. MCH Jabalpur, a tertiary care Hospital, between March 2018 to August 2019. A detailed history taking and clinical examination with nasal endoscopy and relevant preoperative investigations including CECT Nose and PNS and histopathological examination was done in all patients.</p><p class="abstract"><strong>Results: </strong>50 Nasomaxillary swelling patients were selected for this study. 30 patients were male and 20 were females. Ages of patients were varied from 12 years to 72 years. 23 patients (46%) were malignant and 27 (54%) were benign. Histopathological examination results shows benign lesions like JNA (6 cases), fungal sinusitis (6 cases), dermoid cyst (1 case), inverted papilloma (3 cases), sebaceous cyst (1 case), jaw lesions (10 cases), (odontogenic like radicular/ infected cyst, dentigerous cyst, cystic ameloblastoma and non-odontogenic like fibrous dysplasia) and malignant lesions like SCC (squamous cell carcinoma) (12 cases), spindle cell sarcoma (2 cases), undifferentiated carcinoma (3 cases), adenocarcinoma (3 cases), adenoid cystic carcinoma (1 case), Invasive pleomorphic sarcoma (1 case) and malignant melanoma (1 case). SCC was most common lesion f/b JNA and fungal sinusitis. Well differentiated SCC was most common histological type (10 out of 12 cases of SCC). Most common symptom was nasal obstruction (66% cases) f/b epistaxis (52% cases) but epitasis was most common symptom among malignant and JNA cases. In 6 cases (3 JNA, 1 inverted papilloma, 1 malignancy and 1 radicular cyst) radiological diagnosis were not correlated with histological findings.</p><p class="abstract"><strong>Conclusions: </strong>Most our cases were malignant nasomaxillary lesions followed by fungal sinusitis and JNA. Most patients presented in advanced stage of disease so rapidly evaluation including nasal endoscopy should be done. CECT scan is essential to determine tumors extent and bony lesions. All patients should undergo hisotopatholigical examination. The final diagnosis should be made on the basis of clinical, radiological and histopathological findings.</p>

scholarly journals A Rare Case of Radicular Dens in Dente diagnosed by Clinical, Radiographic, Tomographic, and Histopathological Examinations

2017 ◽  
Vol 6 (1) ◽  
pp. 39-43
Author(s):  
Fabricio K de Carvalho ◽  
Ana PD Moreno ◽  
Jorge E León ◽  
Eduardo P Zanella ◽  
Alexandra M de Queiroz ◽  
...  
Keyword(s):  
Rare Case ◽  
Histopathological Examination ◽  
Treatment Plan ◽  
Final Diagnosis ◽  
Radiographic Examination ◽  
Supernumerary Tooth ◽  
Dental Anomaly ◽  
Dens In Dente ◽  
Tomography Scan ◽  
Dens Invaginatus

ABSTRACT Dens invaginatus is a dental anomaly caused by an invagination of enamel that affects in most of the cases the crown of the tooth. The treatment depends on the degree of invagination and morphological involvement. This report describes a dental anomaly affecting the permanent lower lateral incisor of a 13-year-old patient, which resulted in swelling, pain, and dental impaction. The initial radiographic examination suggested a gemination, a fusion with a supernumerary tooth or a dens invaginatus extending to the root. For more accurate diagnosis and treatment plan of this anomaly, computed tomography scan was performed, which revealed the presence of enamel in the root. Due to pain and the impossibility of performing an orthodontic traction, the treatment of choice in this case was dental extraction. The final diagnosis was confirmed by histopathological examination and revealed the rare occurrence of a radicular dens invaginatus. How to cite this article Moreno APD, de Carvalho FK, de Queiroz AM, León JE, Zanella EP, De Rossi A. A Rare Case of Radicular Dens in Dente diagnosed by Clinical, Radiographic, Tomographic, and Histopathological Examinations. Int J Experiment Dent Sci 2017;6(1):39-43.

scholarly journals Computed tomographic evaluation of inflammatory sinonasal diseases

2017 ◽  
Vol 5 (2) ◽  
pp. 537
Author(s):  
Rashmi Kandukuri ◽  
Suresh Phatak
Keyword(s):  
Sensitivity And Specificity ◽  
Histopathological Examination ◽  
Anatomical Variations ◽  
Final Diagnosis ◽  
Sinus Surgery ◽  
P Value ◽  
Fungal Culture ◽  
Fungal Sinusitis ◽  
Ct Diagnosis ◽  
Diagnostic Modality

Background: Computed Tomography plays a major diagnostic role in patients with inflammatory sinonasal diseases and determines the mode of management by displaying the complex osteomeatal anatomy, determining anatomical variations, extent of disease and characterizing various inflammatory sinonasal diseases. Purpose of the study was to assess the role of CT in evaluation of inflammatory sinonasal diseases by evaluating the sensitivity and specificity of CT in diagnosis of various inflammatory Sinonasal diseases.Methods: In this hospital based prospective study 122 patients with symptomatic inflammatory sinonasal diseases were evaluated by 16 slice MDCT. CT diagnosis is correlated with final diagnosis obtained from findings of nasal endoscopy/Functional Endoscopic Sinus Surgery, histopathological examination and fungal culture. Statistical analysis was done by descriptive and inferential statistics using Test statistics (sensitivity, specificity, PPV, NPV and accuracy) and Z test for single proportions (Z value >1.96 is considered significant). Software used in the analysis was SPSS 17.0 version and graph pad prism 6.0 version and p <0.05 is considered as level of significance.Results: On correlating CT diagnosis with final diagnosis, Chronic Sinusitis had 98.41% sensitivity and 96.61% specificity, fungal sinusitis had 66.67% sensitivity and specificity 99.14%, polyps had sensitivity of 94.59% and specificity of 97.6%, the rest of the inflammatory conditions had sensitivity 93.7 % and 99% specificity. P value in all instances was <0.05, i.e. <0.0001, indicating the significance of the findings.Conclusions: CT is the diagnostic modality of choice in evaluation of various inflammatory pathologies and associated complications thereby planning the further management of the patient.

scholarly journals Study to Determine the Incidence of Allergic Fungal Sinusitis among Patients with Nasal Polyps and Its Related Risk Factors

2021 ◽  
Vol 15 (7) ◽  
pp. 1860-1863
Author(s):  
Bakht Zada ◽  
Ejaz Ahmed ◽  
Muhammad Habib ◽  
Zafar Iqbal ◽  
Rehan Saleem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nasal Septum ◽  
Nasal Polyps ◽  
Bone Erosion ◽  
Histopathological Examination ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Deviated Nasal Septum ◽  
Allergic Fungal Sinusitis ◽  
Turbinate Hypertrophy

Aim: To govern the incidence of allergic fungal sinusitis in patients with nasal polyposis. Various anatomical risk factors were also investigated, including turbinate hypertrophy, deviated nasal septum and comorbidities such as asthma and diabetes. Study Design: This is a Descriptive cross-sectional study. Place and duration of study:The study was conducted at ENT Head &Neck Surgery department, Lady Reading Hospital MTI, Peshawar and Azra Nahid Medical College, Lahore for the duration of six months from May 2020 to October 2020. Methods: 110 patients with nasal polyps were evaluated and operated on. Samples were sent for histopathological examination and culture. All patients were assessed with clinical examination and detailed history. Laboratory tests were performed including complete blood counts, urea, electrolytes, ECG and chest radiographs for the suitability of general anesthesia as a prerequisite for surgery. In 95% of cases, computed tomography was recommended to check for sinus involvement, bone erosion, osteo-hypertrophic complex, turbinate hypertrophy, nasal septal deviation, and intracranial and intra-orbital enlargement. MRI examinations were also recommended in cases of suspected intraocular and intracranial disease (5%). Data was scrutinized on a computer using SPSS version 22.0. Results:Of the 110 patients, 65 were male and 45 were female, with a mean age of 1and ranged from 7 to 80 years. All patients had nasal polyps. The incidence of AFS was approximately 29.1% and the remaining 78 had a different pathology. Major deviation of the nasal septum and bilateral hypertrophy of the inferior turbinate’s were observed in 6 (18.7%) and 4 (12.5%) patients, respectively. Unilateral nasal polyps were observed in 7 (21.9%) patients and bilateral nasal polyps in 18 (52.3%). 19/32 (59.4%) of the cases underwent functional endoscopic surgery of the paranasal sinuses, and in 6 (18.7%) external fronto-ethmoidectomy. Two patients underwent nasal ethmoidectomy. Septoplasty and endoscopic sinus surgery were performed in a total of 3 (9.37%) cases. Key words:Allergic bronchopulmonary aspergillosis (ABPA), Allergic fungal sinusitis (AFS).

scholarly journals HISTOPATHOLOGICAL SPECTRUM OF SALIVARY GLAND LESIONS WITH CLINICAL CORRELATION

2020 ◽  
pp. 1-3
Author(s):  
Radhika Mucharla ◽  
Ravikanth Kotagiri
Keyword(s):  
Salivary Gland ◽  
Clinical Laboratory ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Final Diagnosis ◽  
Research Centre ◽  
Benign Tumors ◽  
Salivary Gland Tumours ◽  
Chronic Sialadenitis ◽  
Neoplastic Lesions

Salivary gland tumours account for 2-6.5% of all the neoplasms of the Head and Neck. Histopathology is most important in diagnosis of salivary gland tumors. AIMS and OBJECTIVES : To study age,sex and site distribution of various salivary gland lesions, to study the histomorphologic (gross &microscopic) aspect of these lesions to correlate clinical diagnosis with that of histopathologic features. MATERIALS AND METHODS: The study is conducted in the RAINBOW CLINICAL LABORATORY AND RESEARCH CENTRE, SIDDIPET during the period of September2018 to September 2020. Formalin fixed ,paraffin embedded sections and stained with hematoxylin and eosin slides were studied. RESULTS: Total number of specimens were 54. Out of these 39 were neoplastic (benign 70%,malignant 30%) and 15 were non neoplastic. Among the benign tumors majority are pleomorphic adenoma.Among the malignant tumors, mucoepidermoid carcinoma is the most common. Among the non neoplastic lesions chronic sialadenitis is most common. CONCLUSION: Histopathological examination of salivary gland lesions stands out to be the most important method in establishing the final diagnosis. It helps in differentiating non neoplastic and neoplastic lesions.

scholarly journals Peripheral odontogenic myxoma: Clinical case with a literature review

2021 ◽  
Vol 10 (6) ◽  
pp. e26910615797
Author(s):  
Carlos Eduardo Nogueira Nunes ◽  
Anne Diolina Araújo Morais ◽  
João Victor Morais de Lima ◽  
Filipe Nobre Chaves ◽  
Marcelo Bonifácio da Silva Sampieri ◽  
...  
Keyword(s):  
Literature Review ◽  
Histopathological Examination ◽  
Excisional Biopsy ◽  
Final Diagnosis ◽  
Ossifying Fibroma ◽  
Histopathological Diagnosis ◽  
Odontogenic Myxoma ◽  
Long Term Follow Up ◽  
The Right ◽  
Age Range

Peripheral odontogenic myxoma (POM) is a rare and extra-osseous variant of odontogenic myxoma (OM), classified as a relatively rare benign odontogenic tumor, yet presenting locally aggressive behavior. The objective this manuscript is to report a case of POM in a 75-year-old patient, located in the right maxilla, and in addition, to perform a literature review of the data in relation to clinical, radiographic aspects, hypothesis of diagnosis, and treatment. A male patient, 75 years old, clinical examination constact the presence of a nodule, with a smooth surface, on the right upper alveolar ridge, measuring 20 x 25 mm, with a color similar to the mucosa, a softened consistency, involving teeth 14 and 15, and with an undetermined time of evolution was observed. The diagnostic hypothesis was a peripheral ossifying fibroma and differential diagnosis of peripheral giant cell lesion. An excisional biopsy was performed together with extraction of the involved teeth. Histopathological examination and histochemical reaction was confirm the histopathological diagnosis of POM. The reported case is extremely rare due to the clinical presentation of the lesion, causing bone resorption with tooth mobility. In addition, the age range of involvement is very different from that presented in the literature, between the second and fourth decade of life. The final diagnosis was very important, as it is a lesion with a great potential for recurrence, long-term follow-up should be more careful, and in case of recurrence, a new intervention must be performed.

scholarly journals Uncommon and Atypical Sinonasal Masses: Diagnostic and Therapeutic Challenges

2012 ◽  
Vol 5 (3) ◽  
pp. 114-117 ◽  
Author(s):  
Vinit Kumar Sharma ◽  
Rohit Sharma ◽  
Rajneesh Madhok ◽  
Tanu Agarwal ◽  
Ashish Mehrotra ◽  
...  
Keyword(s):  
Nasal Polyps ◽  
Histopathological Examination ◽  
Neck Surgery ◽  
Final Diagnosis ◽  
Radiological Investigation ◽  
Endoscopic Techniques ◽  
Delay In Diagnosis ◽  
Computed Tomographic ◽  
Modes Of Presentation ◽  
Wide Range

ABSTRACT Introduction Sinonasal masses are a wide range of pathologies ranging from simple nasal polyps to rare tumors like esthesioneuroblastomas. Early symptoms of all of them are similar to common nasal and sinus problems, hence, producing a delay in diagnosis. Materials and methods All the patients presenting with sinonasal masses in the Department of ENT and Head/Neck Surgery, SRMS Institute of Medical Sciences, Bareilly, were included in the study. The study was carried out between January 2007 and December 2011. Detailed history and ENT examination were recorded. Radiological investigation was carried out in the form of computed tomographic (CT) scan of nose and paranasal sinuses. Final diagnosis was made by histopathological examination either before instituting any form of treatment or by a postsurgical biopsy where surgery was carried out. Immunohistochemistry was done in some cases as deemed necessary by the pathologist. Thus, their modes of presentation, radiological and histopathological profiles were studied along with dilemmas in diagnosis and management. Results A total of 189 nasal masses were observed during this period. Out of which 126 were diagnosed as nasal polyps and were excluded from the study. Thus, 63 uncommon nasal masses were seen in the study period. A large number of uncommon sinonasal masses had atypical presentation and/or presented in an advanced stage to pose a diagnostic and surgical challenge. Endoscopic techniques are becoming a gold standard in surgical resection in most of them. Interdepartmental cooperation is highly essential. How to cite this article Sharma R, Sharma VK, Madhok R, Agarwal T, Mehrotra A, Kochhar A. Uncommon and Atypical Sinonasal Masses: Diagnostic and Therapeutic Challenges. Clin Rhinol An Int J 2012;5(3):114-117.

scholarly journals Histopathological Examination in the Categorization of fungal Rhinosinusitis - a Retrospective Study

2021 ◽  
Vol 4 (2) ◽  
pp. 478-481
Author(s):  
Sangeetha Kandasamy ◽  
Megala Chandrasekar ◽  
Thamilselvi Ramachadran
Keyword(s):  
Clinical Diagnosis ◽  
Gold Standard ◽  
Nasal Polyps ◽  
Histopathological Examination ◽  
Clinical Suspicion ◽  
Fungal Sinusitis ◽  
Medical College ◽  
Fungal Rhinosinusitis ◽  
Hematoxylin And Eosin ◽  
Made In

Introduction: Fungal Rhinosinusitis is broadly defined as any sinonasal pathology related to the presence of fungi and is increasingly recognized worldwide. This study aimed to assess and ascertain the need for histopathological examination in the management of fungal Rhinosinusitis. Materials and Methods:  This study was performed over two years, from April 2019 to April 2021, in the Department of Pathology, Vinayaka Missions KirupanandaVariyar Medical College and Hospital, Salem. A total of 383 cases of rhinosinusitis/nasal polyps were studied. Histopathological examination and categorization were done and compared with clinical diagnosis. Results: Only 4/18 cases of acute fungal Rhinosinusitis were correctly diagnosed(22.22%). Nineteen cases of the fungal ball were diagnosed, but none was correctly categorized. Clinical suspicion of fungal sinusitis was present in 10 cases of Rhinosinusitis, which turned out to be chronic Rhinosinusitis in histopathology. In AFRS, fungal elements were overlooked in Hematoxylin and Eosin stained slides and identified only by Grocottmethenamine silver in one-fourth of the cases. Conclusions: Though clinical diagnosis was made in 86% of fungal rhinosinusitis cases, correct categorization was done only in one-third of cases. CT scan could diagnose 60% of cases, but none was categorized. As treatment depends on the type of fungal Rhinosinusitis, histopathological examination is the gold standard for diagnosing and treating fungal Rhinosinusitis.

scholarly journals Endoscopic Treatment of Isolated Sphenoid Sinus Disease in Children

2019 ◽  
Vol 98 (7) ◽  
pp. 425-430 ◽  
Author(s):  
Peng-peng Wang ◽  
Wen-tong Ge ◽  
Xin Ni ◽  
Li-xing Tang ◽  
Jie Zhang ◽  
...  
Keyword(s):  
Paranasal Sinus ◽  
Sphenoid Sinus ◽  
Low Dose ◽  
Case Series ◽  
Ct Imaging ◽  
Benign Tumors ◽  
Ossifying Fibroma ◽  
Juvenile Xanthogranuloma ◽  
Sinus Disease ◽  
Postnasal Drip

In this article, we explore the disease spectrum and clinical characteristics of and the diagnosis and endoscopic approach to treating isolated sphenoid sinus disease (ISSD) in children. To these ends, we review a case series of 19 patients (mean age: 8.1 ± 4.9 years, range: 1.1-15 years, median age: 6.7 years, 13 males, 6 females) who underwent surgical treatment at our hospital for ISSD during the 4 years between 2012 and 2016. The symptoms of pediatric sphenoid sinus disease tend to be variable and nonspecific and include atypical headache, nasal congestion, epistaxis, postnasal drip, snoring, and impaired vision. Headache is the presenting symptom in 42% of patients, but headaches occurred in no specific or typical location. Ten patients underwent preoperative endoscopic examination, and abnormalities in the sphenoethmoidal recess were found in 6 (60%) of these 10 patients. All 19 patients underwent ultra-low-dose paranasal sinus computed tomography (CT) imaging, and 9 patients with suspected tumors or sphenoid mucoceles were further examined by magnetic resonance imaging (MRI). The endoscopic transostial approach was performed in all 19 patients: 16 patients received excision of inflammatory sphenoid sinus disorders and benign tumors, including sphenoid sinusitis, sphenoid sinus mucocele, sphenoid sinus polyp, and ossifying fibroma; 3 patients with suspected tumors received biopsies to detect rhabdomyosarcoma, Langerhans cell histiocytosis, and juvenile xanthogranuloma. No intraoperative or immediate postoperative complications were observed. Children with opacified sphenoid sinus identified by radiographic imaging presented a variety of pathologies. The most common lesions were associated with inflammatory disease. Because the symptoms of pediatric sphenoid sinus disease tend to be variable and nonspecific, CT remains the standard for evaluating sphenoid sinus disease, and ultra-low-dose paranasal sinus CT imaging is recommended and can provide images of equal or better quality compared with those obtained by standard dose CT. In addition, MRI is an essential adjunct in the diagnosis and selection of treatment for suspected tumors of the sphenoid sinus. The endoscopic transostial approach was especially suitable for the management of pediatric benign isolated sphenoid sinus lesions.

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