ABSTRACT
Inverted Schneiderian papilloma (ISP) is a neoplasm of epithelial lining origin which arises in the respiratory mucosa that lines the nasal cavity and paranasal sinuses. The inverted Schneiderian papilloma frequently appears as a unilateral lesion in the nasal septum and extends secondarily to the nasal and paranasal sinuses. This paper reports an unusual case of this pathology with involvement of the oral cavity in a 61-year-old white man. Clinical evaluation revealed a vegetating mass in the alveolar ridge of the right maxilla that had been present for approximately 4 months. After radiographic evaluation, involvement of the maxillary sinus was detected. Microscopic evaluation, in situ hybridization and immunohistochemical analysis of the specimen led to a diagnosis of ISP moderate dysplasia associated with HPV infection.
Subject(s)
Mouth Neoplasms/pathology , Papilloma, Inverted/pathology , Papillomavirus Infections/complications , Paranasal Sinus Neoplasms/pathology , Humans , Immunohistochemistry , In Situ Hybridization , Male , Middle Aged , Mouth Neoplasms/diagnosis , Mouth Neoplasms/virology , Neoplasm Invasiveness , Papilloma, Inverted/diagnosis , Papilloma, Inverted/virology , Papillomavirus Infections/diagnosis , Paranasal Sinus Neoplasms/diagnosis , Paranasal Sinus Neoplasms/virologyABSTRACT
O papiloma invertido schneideriano é uma neoplasia de origem no epitélio de revestimento que surge da mucosa respiratória revestindo a cavidade nasal e os seios paranasais. Frequentemente, surge como uma lesão unilateral no septo nasal e estende-se secundariamente para o nariz e os seios paranasais. Este trabalho relata um caso incomum desta patologia, com o envolvimento da cavidade oral em um homem branco, de 61 anos de idade, cuja avaliação clínica revelou uma massa vegetante no rebordo alveolar direito da maxila, com duração de aproximadamente 4 meses. Após avaliação radiográfica, constatouse o envolvimento do seio maxilar. A análise microscópica, hibridização in situ e análise imunoistoquímica da peça cirúrgica levaram a um diagnóstico de displasia moderada em PIS associado à infecção por HPV.
Inverted Schneiderian papilloma (ISP) is a neoplasm of epithelial lining origin which arises in the respiratory mucosa that lines the nasal cavity and paranasal sinuses. The inverted Schneiderian papilloma frequently appears as a unilateral lesion in the nasal septum and extends secondarily to the nasal and paranasal sinuses. This paper reports an unusual case of this pathology with involvement of the oral cavity in a 61-year-old white man. Clinical evaluation revealed a vegetating mass in the alveolar ridge of the right maxilla that had been present for approximately 4 months. After radiographic evaluation, involvement of the maxillary sinus was detected. Microscopic evaluation, in situ hybridization and immunohistochemical analysis of the specimen led to a diagnosis of ISP moderate dysplasia associated with HPV infection.
Subject(s)
Humans , Male , Middle Aged , Mouth Neoplasms/pathology , Papilloma, Inverted/pathology , Papillomavirus Infections/complications , Paranasal Sinus Neoplasms/pathology , Immunohistochemistry , In Situ Hybridization , Mouth Neoplasms/diagnosis , Mouth Neoplasms/virology , Neoplasm Invasiveness , Papilloma, Inverted/diagnosis , Papilloma, Inverted/virology , Papillomavirus Infections/diagnosis , Paranasal Sinus Neoplasms/diagnosis , Paranasal Sinus Neoplasms/virologyABSTRACT
In this article we present 2 cases of necrotizing sialometaplasia (NS) associated with angiocentric lymphoma of the midline. Immunohistochemical analysis confirmed a T-cell origin, and in situ hybridization in one case revealed its relationship to Epstein-Barr virus. These findings suggest that vascular occlusion by the neoplastic cells produces ischemia, which leads to local infarction contributing to the salivary gland lesion. To our knowledge, the association between angiocentric lymphoma and NS has been previously reported in only one instance, and we suggest that this particular type of lymphoma should be added to the list of related conditions for NS.
Subject(s)
Epstein-Barr Virus Infections/complications , Lymphoma, T-Cell/complications , Palatal Neoplasms/complications , Paranasal Sinus Neoplasms/complications , Sialometaplasia, Necrotizing/diagnosis , Sialometaplasia, Necrotizing/etiology , Adult , Epstein-Barr Virus Infections/diagnosis , Female , Herpesvirus 4, Human/genetics , Herpesvirus 4, Human/isolation & purification , Humans , In Situ Hybridization , Lymphoma, T-Cell/pathology , Lymphoma, T-Cell/therapy , Lymphoma, T-Cell/virology , Male , Palatal Neoplasms/pathology , Palatal Neoplasms/therapy , Palatal Neoplasms/virology , Palate , Paranasal Sinus Neoplasms/pathology , Paranasal Sinus Neoplasms/therapy , Paranasal Sinus Neoplasms/virology , Salivary Glands/blood supply , Salivary Glands/pathology , Sialometaplasia, Necrotizing/pathology , Sialometaplasia, Necrotizing/therapyABSTRACT
Sinonasal lymphomas of T cell or natural killer cell (T/NK cell) phenotype represent a subset of extranodal head and neck lymphomas. T/NK cell sinonasal lymphomas have been described in diverse geographic settings, including China, Japan, Peru, Northern Europe, and North America. The frequency of these lymphomas is highly dependent on the geographic location in which they occur, their incidence being low in Europe and North America and relatively high in Asian countries and in Peru. Regardless of their geographic location, they are typically associated with the Epstein-Barr virus (EBV). Few studies have addressed the relative frequency of sinonasal lymphoma within the group of extranodal head and neck lymphomas. We investigated the anatomic distribution, immunophenotypical profile, and EBV status of 33 cases of extranodal head and neck lymphoma from patients in Guatemala. The anatomic distribution of these lymphomas is similar to that seen in Asian countries: 17 (52%) in the sinonasal area, five (15%) in the palate, and 11 (33%) in other locations. Fifteen (88%) of the 17 sinonasal lymphomas showed a T or null cell phenotype with a strong association with EBV by in situ hybridization. Most Guatemalan patients with these lymphomas were of Mayan descent. In Guatemala, the relative frequency of sinonasal lymphomas within the group of head and neck lymphomas is significantly higher than that reported for Western countries. In addition, the relative frequency of T/NK versus B cell sinonasal lymphomas is higher than that described in North America and similar to that observed in Asian countries and Peru.