Objective:To compare the clinical characteristics of nasal NK/T-cell lymphoma（NKTL） and diffuse large B-cell lymphoma（DLBCL） to improve the diagnosis and differential diagnosis of nasal lymphomas. Methods:A retrospective analysis of cases of nasal NKTL and DLBCL was conducted. The clinical symptoms, signs, and imaging features of both groups were compared and statistically analyzed. Results: The DLBCL group showed more symptoms like exophthalmos/diplopia and epiphora compared to the NKTL group （both P=0.040）. NKTL cases were more likely to be misdiagnosed as sinusitis（P=0.007）. In NKTL cases, nasal mucosal swelling（P<0.01）, destruction of nasal structures（P=0.002）, and external nasal structural abnormalities（P=0.003） were more prevalent. In imaging, the DLBCL group more commonly demonstrated worm-eaten destruction of sinus bones （P=0.004）, sinus masses （P=0.018）, and invasion of adjacent structures including the pterygopalatine fossa, infratemporal fossa （P<0.01）, orbit （P=0.039）, and skull base （P=0.011）. NKTL involved the turbinates（P=0.001）, nasal cavity and septum（P=0.016）, nasopharynx（P<0.01）, and "skip" infiltration of external nasal tissues（P=0.042） more frequently. No statistically significant differences were found in other clinical features between the two groups. Conclusion:For patients with nasal obstruction and discharge, it is essential to inquire about systemic B symptoms, such as fever, and eye symptoms, such as periorbital swelling, diplopia, and lacrimation. Lymphoma should be suspected if local examination reveals diffuse nasal swelling, destruction of turbinates or septum, and external nasal structural abnormalities. Worm-eaten bone destruction and "cast-like" changes of the turbinates, septum, and nasal cavity, as well as "skip" infiltration of the external nose, are more common in NKTL. Sinus masses with invasion of the pterygopalatine fossa, infratemporal fossa, skull base, and orbit are more typical of DLBCL.
Humans ; Retrospective Studies ; Lymphoma, Extranodal NK-T-Cell/diagnosis* ; Lymphoma, Large B-Cell, Diffuse/pathology* ; Nasal Cavity/pathology* ; Male ; Diagnosis, Differential ; Female ; Middle Aged ; Nose Neoplasms/diagnosis* ; Adult ; Aged

OBJECTIVES: To investigate the clinical and pathological features of patients with unilateral sinonasal disease (USD). METHODS: A retrospective analysis was completed on 376 adult patients with USD from January 2015 to December 2016. Their presenting symptoms, nasal endoscope, CT scanning, and pathology were analyzed respectively. RESULTS: Among the 267 (71.01%) patients with inflammatory disease, there were 4 pathological types. And there were 8 pathological types in 60 (15.96%) patients with benign tumor. Of the 49 patients with malignant tumor, there were 15 pathological types which included squamous carcinoma, malignant melanoma, and lymphoma, as well as myoepithelial carcinoma and Mesodermal mesoderm. The onset age of inflammation group was younger than that of benign (<0.05) or malignant tumor groups (<0.05). The misdiagnosis rate was 8.33% in benign tumor (5/60), and 10.20% in malignant tumor (5/49). Nasal polyps was the most common misdiagnosis in the groups of benign and malignant tumor. CONCLUSIONS The pathology of adult patients with USD is complicated, and no specific clinical feature was found for distinguishing between benign and malignant lesions. The tumor took a quite proportion in adult patients with USD. Therefore, careful consideration should be taken before diagnosing patients with USD in order to reduce misdiagnosis rate.
Adult ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; therapy ; Humans ; Melanoma ; diagnosis ; pathology ; therapy ; Nasal Cavity ; Nasal Polyps ; Nose Neoplasms ; diagnosis ; pathology ; therapy ; Retrospective Studies

BACKGROUND: Jeju Island is geographically and socioeconomically distinct from the mainland of South Korea. Thus, the presentation and management of non-melanocytic skin cancers (NMSC) of the head and neck may differ from those in other regions of the country. We compared the clinical characteristics and treatment modalities of NMSC on Jeju Island with the findings of similar regional studies. METHODS: Patient data, including age, sex, diagnosis, tumor site, treatment, and recurrence, were obtained from the medical and pathology records of patients diagnosed with NMSC between January 2010 and June 2015. RESULTS: In total, 190 patients (57 men) with a mean age of 75 years (range, 42–97) were assessed. Overall, 203 NMSCs were diagnosed, including 123 basal cell carcinomas and 80 squamous cell carcinomas. The tumor sites included the nose, cheeks, periorbital area, and lips (n=55, 54, 25, and 20, respectively). We identified 92 T1-stage and 60 T2-stage tumors, and 120 cases were treated with wide surgical resection and 17 cases were treated with radiation therapy at the medical center. Of the 120 cases treated surgically, 69 required reconstructive surgery using a local skin flap, 22 required full-thickness skin grafting, and 12 underwent primary closure. Basal and squamous cell carcinomas recurred in 2 and 1 cases, respectively. CONCLUSIONS: Compared to the reports from other regions, the average patient age was 10 years higher, with a marked female preponderance. While the proportion of squamous cell carcinoma was higher than in other regions, the tumor distribution and surgical management profiles were similar.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cheek ; Clinical Study* ; Diagnosis ; Female ; Head* ; Humans ; Korea ; Lip ; Neck* ; Nose ; Pathology ; Recurrence ; Skin Neoplasms* ; Skin Transplantation ; Skin*

OBJECTIVES: To retrospectively evaluate the patients who underwent nasopharyngeal biopsy with imaging and biopsy results, who have or don’t have symptoms for nasopharyngeal pathology and to determine the ratio of the nasopharyngeal cancer cases and other pathologic conditions. METHODS: In this retrospective study, 983 patients who underwent endoscopic nasopharyngeal biopsy for symptomatic nasopharyngeal lesions were included. All pathological results, benign or malign was recorded and classified due to the patients’ presenting symptoms such as symptomatic for nasopharyngeal pathology or asymptomatic. Computed tomography (CT) or magnetic resonance imaging (MRI) reports were also recorded separately as group A for malignancy or group B for not malignancy. RESULTS: Forty-five (4.6%) of 983 biopsies were malignant. In this group, there is no statistically significant difference between symptomatic and asymptomatic group. For malignant pathologies, the sensitivity of MRI was found 88.2% and CT was 61.5%. CONCLUSION: For early diagnosis of nasopharyngeal cancer, all patients admitted to Ear, Nose and Throat (ENT) referral clinics should be examined endoscopically irrespective of their complaints and suspicious cases should be investigated by imaging especially by MRI. If MRI report clearly indicates Thornwaldt cyst or reactive lymphoid hyperplasia and this result is compatible with endoscopic findings, biopsy may not be necessary. Apart from these cases, all suspected lesions should be biopsied.
Adult* ; Biopsy* ; Ear ; Early Diagnosis ; Humans ; Magnetic Resonance Imaging ; Multidetector Computed Tomography ; Nasopharyngeal Neoplasms ; Nasopharynx* ; Nose ; Pathology ; Pharynx ; Pseudolymphoma ; Referral and Consultation ; Retrospective Studies

Synovial sarcoma is a rare tumour found in soft tissue; it is a mesenchymal spindle cell tumour that is not related to the synovial membrane. This tumour has a low incidence, and the most frequent place of occurrence is the lower extremities in young adults. Synovial sarcoma of the head and neck accounts for 3%-5% of sarcomas in this anatomical region. The tumor in the nasal cavity is less than 1%. The treatment of choice for synovial sarcoma of the head and neck is complete surgical excision of the tumour mass followed by adjuvant radiotherapy.
Humans ; Nasal Cavity ; pathology ; Nose Neoplasms ; diagnosis ; radiotherapy ; surgery ; Paranasal Sinuses ; pathology ; Radiotherapy, Adjuvant ; Sarcoma, Synovial ; diagnosis ; radiotherapy ; surgery

We report a rare case of pleomorphic adenoma arising from the nasal septum. A 37-year-old woman presented with a 1-year-history of right-sided occasional epistaxis. Computed tomographic scans revealed an oval mass in the right nasal cavity. The tumor was removed endoscopically with endonasal approach. The microscopic finding showed numbers of myoepithelial cells and duct-like structures consisting of loose myxoid stroma. This lesion had histological characteristics of a pleomorphic adenoma, and this was confirmed by immunohistochemical expression of cytokeratin, S-100 protein and SMA. Her post-operative course was uneventful, and she is currently free from the disease 1.5 years after surgery.
Actins ; metabolism ; Adenoma, Pleomorphic ; diagnosis ; surgery ; Adult ; Endoscopy ; Epistaxis ; Epithelial Cells ; Female ; Humans ; Keratins ; metabolism ; Nasal Septum ; pathology ; Nose Neoplasms ; diagnosis ; surgery ; S100 Proteins ; metabolism

A 59-year-old man was admitted to the Department of Ear, Nose and Throat with a complaint of six-month history of left facial numbness and toothache. There was no special previous medical history in addition to smoking. No obvious abnormality in routine electrocardiogram, chest X-ray, abdominal B ultrasound were found. (1) CT scans showed heterogeneous shadows in maxillary sinus with the lesions on the left max- illary bone and evidently destruction of alveolar bone. The histopathological examination revealed bone tissue which was partly covered by an intact adenocarcinoma cell. (2) Immunohistochemical staining foe CK7, CD117, thyroid transcription factor-1, and novel aspartic proteinase A were positive and thus compatible with metastatic lung adenocarcinoma. (3) Chest CT scans showed a 1 cm x 2 cm mass on the superior lobe of the left lung, with destruction of sternum and rib, confirming that the lesions in the paranasal sinuses were lung cancer metastases. Therefore, this patient conclusively diagnosed as lung adenocarcinoma with multiple bone metastases.
Adenocarcinoma ; diagnosis ; pathology ; Adenocarcinoma of Lung ; Bone Neoplasms ; secondary ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; Male ; Maxillary Sinus ; pathology ; Middle Aged ; Nose Neoplasms ; secondary

A 70 years old male patient complained a sense of swelling on right facial, mild pain, and the obstruction of right nasal, no complain of facial numbness and toothache. Physical examination showed the slight bulging on right facial with mild tenderness, purulent nasal secretions on the right middle nasal meatus, and no significant neoplasm. CT scan showed that soft density tissue in the right maxillary sinus,and the high density tissue in some period. Postoperative diagnosis: carcinoma of maxillary sinus with fungal sinusitis.
Aged ; Carcinoma ; complications ; diagnosis ; Humans ; Male ; Maxillary Sinus ; microbiology ; pathology ; Mycoses ; complications ; Nose Neoplasms ; complications ; diagnosis ; Sinusitis ; microbiology

Humans ; Nasal Cavity ; pathology ; Nose Neoplasms ; diagnosis ; Paranasal Sinuses ; Solitary Fibrous Tumors ; diagnosis

We report a case of a 46 year old female patient with nasal hemangiopericytoma. She complained of left nasal congestion, pus snot for 10 years, sometimes with left nasal bleeding. Physical examination: in the left nasal tract saw red soft neoplasm, roughness surface, easy bleeding when touched. Sinus CT shows: bilateral maxillary sinus, ethmoid sinus, sphenoid sinus and the left posterior nasal cavity lesions, considering inflammation with the formation of polyps, tumor not excluded. The left nasal cavity neoplasm biopsy shows: hemangioma of left nasal cavity. After admission in general anesthesia, we do transnasal endoscopic sinus openning operation and the left nasal cavity neoplasm resection. Postoperative pathological examination shows: the left nasal cavity hemangiopericytoma. Immunohistochemical showed: Vimentin(+), Smooth muscle actin(+), Desmin(-), endothelial cells CD31(-) and CD34(-). No postoperative radiotherapy or chemotherapy, no tumor recurrence. After one year of follow-up, the contact was lost.
Biopsy ; Endoscopy ; Epistaxis ; Ethmoid Sinus ; pathology ; Female ; Hemangiopericytoma ; diagnosis ; pathology ; Humans ; Inflammation ; pathology ; Middle Aged ; Nasal Cavity ; pathology ; Nasal Polyps ; pathology ; Neoplasm Recurrence, Local ; Nose Neoplasms ; diagnosis ; pathology ; Sphenoid Sinus ; pathology