Recently Described Sinonasal Tract Lesions/Neoplasms: Considerations for the New World Health Organization Book

Wenig, Bruce M.

doi:10.1007/s12105-014-0533-9

Cited by 21 publications

(10 citation statements)

References 13 publications

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“…Despite the fact that some smooth muscle tumors may be negative for desmin, one can generally use desmin, especially when it is strongly staining, in addition to the morphology and strength of the actins staining, to separate smooth muscle tumors from NF. The recently described ''Low Grade Sinonasal Sarcoma with Neural and Myogenic features'' [49,50], shows a cellular spindle cell neoplasm with uniform, bland, elongate nuclei, an infiltrative growth pattern, invaginated respiratory gland but with inconspicuous mitoses and a positive reaction with S100 protein and actin.…”

Section: Differential Diagnosismentioning

confidence: 99%

Sinonasal Tract Neurofibroma: A Clinicopathologic Series of 12 Cases with a Review of the Literature

Azani

Bishop

Thompson

2014

Head and Neck Pathol

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Neurofibroma (NF), a benign peripheral nerve sheath tumor, is very uncommon in the sinonasal tract, with only a few reported cases in the English literature. Cases within the files of the authors' institutions confined to the sinonasal tract were compared to cases reported in the English literature (Medline 1966-2014). The 12 patients included 6 females and 6 males, aged 26-75 years (mean 46.2 years). The patients usually presented clinically with a mass lesion (n = 11), obstruction (n = 4) or pain (n = 3), with an average symptom duration of 42.9 months. Two patients had neurofibromatosis (NF1). Tumors involved the nasal cavity alone (n = 8), maxillary sinus alone (n = 2), or mixed sites (n = 2), with a range of 0.4-4.1 cm (mean 2.2 cm). The tumors were circumscribed, composed of spindled to wavy cells with curvilinear nuclei set in a background of collagenized stroma and mast cells. Nuclear palisading and perivascular hyalinization were not seen. Mitoses were scant. Pleomorphism, necrosis and increased cellularity were absent. By immunohistochemistry, the lesional cells were S100 protein, SOX10 and NFP positive, while CD34 highlighted the perineurium. INI1 was intact, with strong nuclear expression in all cases. All patients had surgical excision without recurrence (mean follow-up 8.6 years). The principle differential diagnoses include schwannoma, perineurioma, fibromatosis, and solitary fibrous tumor. NF of the sinonasal tract occurs in middle-aged patients without a gender predilection, usually with non-specific symptoms present for a long duration. Tumors are relatively large (mean 2.2), and usually affect one site only. Surgery is curative, with only 16.7 % NF1 associated. S100 protein, SOX10 and NFP highlight the Schwann cells, with CD34 highlighting the perineural fibroblasts.

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Section: Differential Diagnosismentioning

confidence: 99%

Sinonasal Tract Neurofibroma: A Clinicopathologic Series of 12 Cases with a Review of the Literature

Azani

Bishop

Thompson

2014

Head and Neck Pathol

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“…They encompass benign tumors (benign peripheral nerve sheath tumors, angioleiomyoma and hemangiomas), lesions of low-grade or uncertain biological potential (sinonasal hemangio/glomangiopericytoma, solitary fibrous tumor, desmoid fibromatosis, low-grade malignant peripheral nerve sheath tumors and low-grade sinonasal sarcoma with neural and myogenic features) and frankly malignant aggressive neoplasms (conventional malignant peripheral nerve sheath tumors, leiomyosarcoma, rhabdomyosarcoma and other rare sarcoma types) [1][2][3][4][5]. Due to the rarity of sinonasal mesenchymal neoplasms, many pathologists are not familiar with their broad phenotypic spectrum.…”

Section: Introductionmentioning

confidence: 99%

Angioleiomyoma of the Sinonasal Tract: Analysis of 16 Cases and Review of the Literature

Agaimy

Thompson

2015

Head and Neck Pathol

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Angioleiomyoma (ALM; synonyms: angiomyoma, vascular leiomyoma) is an uncommon benign tumor of skin and subcutaneous tissue. Most arise in the extremities (90 %). Head and neck ALMs are uncommon (~10 % of all ALMs) and those arising beneath the sinonasal tract mucosa are very rare (<1 %) with 38 cases reported so far. We herein analyzed 16 cases identified from our routine and consultation files. Patients included seven females and nine males aged 25-82 years (mean 58; median 62). Symptoms were intermittent nasal obstruction, sinusitis, recurrent epistaxis, and a slow-growing mass. Fifteen lesions originated within different regions of the nasal cavity and one lesion was detected incidentally in an ethmoid sinus sample. Size range was 6-25 mm (mean 11). Histologically, all lesions were well circumscribed but non-encapsulated and most (12/16) were of the compact solid type superficially mimicking conventional leiomyoma but contained numerous compressed muscular veins. The remainder were of venous (2) and cavernous (2) type. Variable amounts of mature fat were observed in four cases (25 %). Atypia, necrosis, and mitotic activity were absent. Immunohistochemistry showed consistent expression of smooth muscle actin (12/12), h-caldesmon (9/9), muscle-specific actin (4/4), variable expression of desmin (11/14) and CD56 (4/6), and absence of HMB45 expression (0/11). The covering mucosa was ulcerated in 6 cases and showed squamous metaplasia in one case. There were no recurrences after local excision. Submucosal sinonasal ALMs are rare benign tumors similar to their reported cutaneous counterparts with frequent adipocytic differentiation. They should be distinguished from renal-type angiomyolipoma. Simple excision is curative.

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“…11 In some cases, as with our patient, rhabdomyoblastic differentiation (11%) has also been reported. 6,7,12 In one of the cases of BSNS, fibroblastic differentiation has been observed 5 and it is currently unknown whether fibroblastic differentiation is a precursor to myogenic differentiation or whether it represents a distinct subset of patients with BSNS with unique local cellular factors leading to fibroblastic differentiation. Another distinctive pathological feature is the entrapment of hyperplastic respiratory epithelium, leading to gland or cyst formation (so-called "pseudo-gland formation") seen in 70% cases.…”

Section: Discussionmentioning

confidence: 99%

Biphenotypic Sinonasal Sarcoma—Case Report and Review of Clinicopathological Features and Diagnostic Modalities

et al. 2018

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Background Biphenotypic sinonasal sarcoma is a recently described malignancy showing dual differentiation with both myogenic and neural elements. Due to its histologic similarities to other sinonasal malignancies, it is a diagnostic challenge. Objective The main purpose of this article is to report a case of biphenotypic sinonasal sarcoma and to consolidate data and provide a comprehensive review regarding pathological differences between biphenotypic sarcoma and other sinonasal malignancies and diagnostic modalities used for biphenotypic sarcoma. Material and Methods A systematic review of all cases of biphenotypic sinonasal sarcoma was performed using electronic databases (PubMed and Medline). Data collected included age, gender, symptoms, sub-site of origin, immunophenotyping, metastasis, recurrence, treatment, duration of follow-up, and survival outcomes. Results Ninety-five cases of biphenotypic sarcoma were found with mean age at diagnosis of 52.36 years (range, 24–87 years). Female to male ratio was 2.27:1. Extra-sinonasal extension was present in 28%. Immunophenotyping revealed that S-100 and SMA (smooth muscle actin) were consistently positive, while SOX-10 was consistently negative. PAX3-MAML3 fusion [t (2; 4) (q35; q31.1)] was the most common genetic rearrangement. Surgical excision with or without adjuvant radiotherapy was the most frequent treatment modality used. Recurrence was observed in 32% of cases with follow-up. None of the cases reported metastasis. Three patients had died at the time of publication that included one case with intracranial extension. Conclusion Biphenotypic sarcoma is distinct sinonasal malignancy with unique clinicopathological features. Testing involving a battery of myogenic and neural immunomarkers is essential for diagnostic confirmation and is a clinically useful endeavor when clinical suspicion is high.

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Recently Described Sinonasal Tract Lesions/Neoplasms: Considerations for the New World Health Organization Book

Cited by 21 publications

References 13 publications

Sinonasal Tract Neurofibroma: A Clinicopathologic Series of 12 Cases with a Review of the Literature

Sinonasal Tract Neurofibroma: A Clinicopathologic Series of 12 Cases with a Review of the Literature

Angioleiomyoma of the Sinonasal Tract: Analysis of 16 Cases and Review of the Literature

Biphenotypic Sinonasal Sarcoma—Case Report and Review of Clinicopathological Features and Diagnostic Modalities

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