Nasopharyngeal biopsy is the removal of a small piece of tissue for subsequent examination under a microscope. Biopsy material can be taken from any area of the skin and mucous membranes, incl. and from the mucous membrane of the nasopharynx. This diagnostic intervention is performed in our clinic under the control of an optical endoscope.
Indications for nasopharyngeal biopsy under endoscopic control
We resort to endoscopic biopsy of the nasopharynx to diagnose tumor processes, and, above all, nasopharyngeal cancer. Cancerous tumors grow from the skin and mucous membranes. Unfortunately, the nasopharyngeal mucosa is no exception in this regard.
About probable availability tumor process in the nasopharynx the following signs indicate:
- mucous and mucopurulent discharge from the external nasal openings on the affected side, not associated with a cold or runny nose
- here is bloody discharge or nosebleeds
- difficulty in nasal breathing due to mechanical obstruction, swelling of the mucous membrane, and displacement of the nasal septum
- nasal voice
- headache
- pain, numbness in certain areas of the face, paralysis of facial muscles.
In some cases, especially in advanced stages, visual and auditory disturbances are possible in the form of a feeling of ear congestion, ringing in the ears, double vision, decreased visual acuity and hearing. However, at first all these symptoms may not be present, and the tumor manifests itself only by an increase cervical lymph nodes.
In this regard, unreasonably enlarged and painful lymph nodes are a cause for concern. The first thing you need to think about is their metastatic damage. However, all the symptoms listed above, incl. and lymph node involvement is not strictly specific for cancer. Perhaps these symptoms are related to benign tumors nasopharynx: fibromas, chondromas, polyps.
The presence of a large tumor formation in the nasopharynx is confirmed by non-invasive tests (not related to penetration into internal environments, and with tissue damage) research methods. These are x-rays, computed tomography and magnetic resonance imaging. Based on the data obtained, we can judge the type of tumor, but only indirectly. The final diagnosis is made only after a biopsy.
Nasopharyngeal biopsy technique
The anatomical features of the initial part of the pharynx, the nasopharynx, are that it is difficult to access for visual inspection and intervention. The pharynx can only be partially examined retrogradely, through oral cavity from the oropharynx using a special mirror.
Endoscopy allows not only to examine the nasopharynx, but also to perform certain types of interventions, incl. and biopsy. A nasopharyngoscope is a type of endoscope for examining the pharyngeal sections. This optical instrument with a flexible probe, equipped with a light source and a video camera.
The device we have in service is connected to a computer. The image of the mucosal area is captured by a video camera and sent through optical fibers to the device and then to the computer. Here the received information is digitized and converted into a multiply enlarged image on the monitor.
Thanks to this, the doctor can easily detect the tumor and determine its location. The nasopharyngoscope is equipped with a special channel for devices with which biopsy material is taken.
The procedure for taking biopsy material is carried out by an otolaryngologist in the endoscopy room of our center. The probe is inserted into the oropharynx through the external nasal opening of the corresponding side, and then through the lower nasal passage, choana (internal nasal opening) into the nasopharynx.
The nasal cavity is first irrigated with sprays of vasoconstrictor and local anesthetic substances to eliminate pain and prevent swelling of the nasal mucosa. To enhance pain relief, the doctor treats the endoscope probe with local anesthetic gel. The end of the probe is rounded so as not to injure the mucous membranes.
During the study, the doctor takes biopsy material and assesses the condition of the mucous membrane of the orifices opening into the oropharynx auditory tubes with tubal tonsils, pharyngeal tonsils. The whole procedure takes about 20 minutes. The conclusion will be available in approximately 7 days. During the first days after the study, short-term painful sensations, nasal congestion.
Contraindications to endoscopic biopsy of the nasopharynx
In many ways they are similar to those for biopsies of other areas:
- colds of the upper respiratory tract
- any other acute infections
- decompensation, exacerbation of existing chronic diseases
- slowing down blood clotting
- mental disorders
- allergies to the drugs used.
Cancer of the nasal cavity and paranasal sinuses is quite rare disease. Only about 3% of malignant tumors of the head and neck are localized in the nasal cavity and paranasal sinuses.
The share is from total number There are even fewer cancers - 0.5%. Men are more prone to this type of disease, and in 80% of cases it affects people over 55 years of age.
Nasal cancer causes
There are a number of factors that increase the risk of this disease:
- Exposure to certain chemicals
- Human papillomavirus (HPV)
- Radiotherapy for hereditary retinoblastoma
Exposure to certain chemicals
Research shows that certain species production work increase the risk of developing this disease. This is due to the effect of certain chemicals on the body.
A number of experts are of the opinion that about a third of cases of this disease are associated with professional activity, including contact with chemicals.
The following reagents may increase the risk of illness:
- Wood dust is hazardous to people who work in carpentry, including making furniture, wood floors, and other types of wood products.
- Tanning dust is dangerous for people working in shoe production.
- Exposure to chromium used in the production of stainless steel, textiles, plastics and leather can be harmful.
- Nickel can also be dangerous and is used in the production of stainless steel.
- Formaldehyde is a chemical used to produce other chemical compounds, as well as for the production of building materials and household goods.
- Fabric fibers pose a threat to people working in the textile industry.
- Mineral oils used as lubricants in the production of metal products and in the operation of machinery are potentially hazardous to persons in contact with them.
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There are many strains of this virus and it can also cause other types of cancer. In more than 20% of cases, cancer of the nose and paranasal sinuses is associated with the presence of HPV in the patient’s body. Of all the varieties of this virus, type number 16 is the most common in this nasal disease.
This is what HPV looks like on the human body
The risk of developing this disease of the nose, as well as the paranasal sinuses, increases with smoking. While smoking tobacco smoke on the way to the lungs it can pass through the nose. The magnitude of the risk is directly proportional to the smoking experience and the volume of tobacco products smoked per day. Persons who have given up this bad habit, is characterized by a decrease in the likelihood of this form of cancer.
Radiotherapy for hereditary retinoblastoma
The danger of developing cancer of the nose and paranasal sinuses under the influence of this type of radiotherapy has been convincingly shown in the course of conducted and published studies.
Possible risk factors
In addition to the clear risk factors for the occurrence of the disease in question, there are also possible:
- Benign neoplasms of the nose
- Past non-Hodgkin's lymphoma
Benign neoplasms of the nose
Some studies have shown that there is an increased risk of this type of nasal and sinus cancer in people with a history of benign neoplasms nose However, the cause-and-effect relationship remains unclear and further research is required.
Past non-Hodgkin's lymphoma
Symptoms of cancer of the nose and paranasal sinuses
Symptoms of nasal and sinus cancer vary depending on the type, location, and stage of the disease. Symptoms characteristic of early types of cancer are similar to those of respiratory infections of the upper respiratory tract.
The key factor that allows you to differentiate the symptoms of cancer of the nose and paranasal sinuses from the symptoms that develop with respiratory infections, is the duration of their presence in the patient.
An upper respiratory tract infection usually resolves within a few weeks if there is adequate medical treatment, and the symptoms associated with cancer do not go away.
In some cases, patients with cancer of the nose and paranasal sinuses do not detect any specific symptoms and signs of disease. The fact is that the types of cancer we are considering are usually diagnosed on late stages, since the symptoms of this disease are usually not expressed at early stages. These types of cancer are often discovered while a patient is being treated for some type of cancer. infectious disease, for example, from sinusitis.
Because nasal cavity borders the eyes, ears and mouth, nasal cancer sometimes causes a feeling of pressure and pain in these areas. This can affect vision and the ability to open your mouth. Cancers nose can also affect the sense of smell.
Symptoms related to the nose:
- Blockage of the passage causing permanent congestion on one side of the nose
- Nose bleed
- Difficulty smelling
- Mucus-like discharge
- Mucus-like discharge in the back of the nose and throat
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The most common are the first two symptoms, which predominate in most cases.
Eye related symptoms:
- Protrusion of one of the eyes
- Complete or partial loss of vision
- Double vision
- Pain above and below the eye
- Increased lacrimation
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Other symptoms:
- Persistent nodules on the face, nose, or palate
- Persistent pain and numbness in certain parts of the face, especially the upper cheek
- Tooth loss
- Difficulty opening the mouth
- Enlargement lymph nodes neck
- Pain or tightness in one ear
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A patient who notices the above symptoms and signs should immediately consult a doctor. This is especially important if symptoms do not stop for several weeks. The doctor is usually interested in the chronology of the development of symptoms, when they appeared and how they developed.
Since many of the above symptoms can be caused by other conditions that are not cancer, it is important not to neglect regular medical examinations from specialists. This is especially important if a person drinks alcohol or tobacco products. In general, persons who use tobacco products and alcohol should undergo a general medical examination at least once a year, even if they do not have any alarming symptoms.
Malignant tumors of the nose and paranasal sinuses
Types of cancer of the nose and paranasal sinuses
Squamous cell carcinoma
This cancer is the most common form of cancer affecting the head and cervical region(more than 60% of the total number of cases). Flat (scaly) cells are similar to skin cells and are part of the lining of the mouth, nose, larynx and throat.
Adenocarcinoma
Adenocarcinoma is the second most common type of cancer of the nose and paranasal sinuses (about 10% of all cases). Adenocarcinoma begins as adenomatous cells located on the surface of the nasal cavity. These cells produce mucus. The number of adenocarcinomas has increased in the last 20 years among the population, the reasons for this are: this moment unknown.
Adenoid cystic carcinoma
Adenoid cystic carcinoma is a rare type of cancer of glandular tissue. It usually hits salivary glands, but occasionally can be localized in the nose and paranasal sinuses.
Lymphoma
Lymphoma usually begins in the lymph nodes. There are many lymph nodes in the neck, and a symptom such as a painless swollen lymph node is the most obvious indicator of the presence of lymphoma.
Plasmacytoma
Plasmacytoma is a tumor composed of plasma cells, similar to myeloma.
Melanoma
Melanomas develop from the pigment cells that give color to the skin. Melanomas of the head and neck can be located anywhere on the skin or inside the nose or mouth.
Esthesioneuroblastoma (olfactory neuroblastoma) and neuroendocrine carcinoma
Neuroendocrine carcinomas are rare species tumors specific to the nasal cavity.
Neuroblastomas develop in the upper part of the nasal cavity. Neuroendocrine carcinoma arises from specialized cells that respond to signals from hormone-producing cells.
Sarcoma
Sarcoma develops from cells that form soft fabrics.
Nose cancer photo:
Stages of cancer of the nasal cavity and paranasal sinuses
Each type of cancer of the nose and paranasal sinuses is characterized by: various symptoms and developmental stages determined by microscopic examination of specimens. This type examination plays an important role in the diagnosis of these diseases.
Nasal cancer diagnosis
Visit doctor
If you are concerned about symptoms that resemble those of the disease in question, you should consult a doctor. A general examination is necessary, as well as careful examination of the nose, throat, ears and eyes. After the examination, a referral is often given for different kinds analyses. Standard blood tests and x-rays are usually performed chest to be sure general condition health. Then the specialized types of examination listed below are carried out.
Nasoendoscopy
During this survey, to minimize painful symptoms often used local anesthetic. The nasal cavity is examined using a nasoendoscope. If the specialist detects a significant anomaly, he can send the patient for panendoscopy. With panendoscopy, it is possible to take a biopsy from an area with pathology.
Biopsy
The only guaranteed way to identify this type of disease is to perform a biopsy of the affected area. Next, a microscopic examination of the sample taken is carried out to look for signs of cancer.
Needle aspiration
If the specialist can feel the growth, it may be necessary to aspirate it with a needle. Sometimes aspiration is performed in parallel with ultrasound scanning for a more accurate analysis. This type of analysis also helps determine whether the cancer has spread to the lymph nodes in the neck. In this case, needle aspiration is done on one of the large nodes in the neck.
Panendoscopy
The doctor may request a panendoscopy if a biopsy is required. This test is carried out under general anesthesia. During it, an examination of the nasal cavity, as well as the larynx, esophagus and trachea is carried out.
If nasal cancer is diagnosed, do not delay treatment, familiarize yourself with the methods successful treatment will help
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Additional examination methods
Additional methods examinations are usually required to determine the specifics of the upcoming treatment. If the above tests reveal cancer, it is usually necessary to determine whether it has spread to other areas of the body.
Method for examining nasal cancer
CT scan
This type of analysis may need to be performed on the head, neck, chest and abdomen. This can reveal the size of the tumor and the presence of enlarged lymph nodes in the neck, as well as possible spread of the cancer to other parts of the body.
This type of examination, compared to a CT scan, allows for better analysis of soft tissue. Both types of scans may require a special dye to be injected into the blood for a more accurate analysis.
Positron emission tomography
This type of scan helps identify areas of active disease. It is also sometimes used to determine whether the disease has returned after treatment. Sometimes this type of examination is done after surgery to make sure there is no scar tissue remaining. cancer cells.
Videos nose cancer
Nasopharyngeal biopsy- taking a small piece of tissue for subsequent examination under a microscope. Biopsy material can be taken from any area of the skin and mucous membranes, incl. and from the mucous membrane of the nasopharynx. This diagnostic intervention is performed in our clinic under the control of an optical endoscope.
Indications for nasopharyngeal biopsy under endoscopic control
TO endoscopic biopsy of the nasopharynx we resort for diagnostics of tumor processes, and, above all, nasopharyngeal cancer. Cancerous tumors grow from the skin and mucous membranes. Unfortunately, the nasopharyngeal mucosa is no exception in this regard.
The following signs indicate the probable presence of a tumor process in the nasopharynx:
- mucous and mucopurulent discharge from the external nasal openings on the affected side, not associated with a cold or runny nose
- here is bloody discharge or nosebleeds
- difficulty in nasal breathing due to mechanical obstruction, swelling of the mucous membrane, and displacement of the nasal septum
- nasal voice
- headache
- pain, numbness in certain areas of the face, paralysis of facial muscles.
In this regard, unreasonably enlarged and painful lymph nodes are a cause for concern. The first thing you need to think about is their metastatic damage. However, all the symptoms listed above, incl. and lymph node involvement is not strictly specific for cancer. Perhaps these symptoms are associated with benign tumors of the nasopharynx: fibroids, chondromas, polyps.
The presence of a large tumor formation in the nasopharynx is confirmed by non-invasive (not associated with penetration into internal environments or tissue damage) research methods. These are x-rays, computed tomography and magnetic resonance imaging. Based on the data obtained, we can judge the type of tumor, but only indirectly. The final diagnosis is made only after a biopsy.
Nasopharyngeal biopsy technique
The anatomical features of the initial part of the pharynx, the nasopharynx, are that it is difficult to access for visual inspection and intervention. The pharynx can only be partially examined retrogradely, through the oral cavity from the oropharynx using a special mirror.
Endoscopy allows not only to examine the nasopharynx, but also to perform certain types of interventions, incl. and biopsy. A nasopharyngoscope is a type of endoscope for examining the pharyngeal sections. This is an optical device with a flexible probe, equipped with a light source and a video camera.
The device we have in service is connected to a computer. The image of the mucosal area is captured by a video camera and sent through optical fibers to the device and then to the computer. Here the received information is digitized and converted into a multiply enlarged image on the monitor.
Thanks to this, the doctor can easily detect the tumor and determine its location. The nasopharyngoscope is equipped with a special channel for devices with which biopsy material is taken.
The procedure for taking biopsy material is carried out by otolaryngologist in the endoscopy room of our center. The probe is inserted into the oropharynx through the external nasal opening of the corresponding side, and then through the lower nasal passage, choana (internal nasal opening) into the nasopharynx.
The nasal cavity is first irrigated with sprays of vasoconstrictor and local anesthetic substances to eliminate pain and prevent swelling of the nasal mucosa. To enhance pain relief, the doctor treats the endoscope probe with local anesthetic gel. The end of the probe is rounded so as not to injure the mucous membranes.
During the study, the doctor takes biopsy material and evaluates the condition of the mucous membrane, the mouths of the auditory tubes with tubal tonsils that open into the oropharynx, and the pharyngeal tonsil. The whole procedure takes about 20 minutes. The conclusion will be available in approximately 7 days. During the first days after the study, short-term painful sensations and nasal congestion are possible.
Contraindications to endoscopic biopsy of the nasopharynx
In many ways they are similar to those for biopsies of other areas:
- colds of the upper respiratory tract
- any other acute infections
- decompensation, exacerbation of existing chronic diseases
- slowing down blood clotting
- mental disorders
- allergies to the drugs used.
Schneiderian papillomas are benign epithelial tumors that most often occur in adults and are associated with human papillomavirus (HPV). Most often they are localized on one side, but in rare cases they can affect several anatomical areas. Three variants of Schneiderian papillomas have been described.
Exophytic papillomas in the vast majority of cases, they are localized on the nasal septum, in the form of leaf-shaped papillary islands with a central fibrovascular core and thickened, non-keratinizing squamous epithelium. Inverted papillomas are the most common form. They amaze lateral wall The nasal cavities and paranasal sinuses (most often the maxillary) are characterized by endophytic growth, similar to the growth of non-keratinizing squamous epithelium.
Oncocytic papillomas(cylindrocellular) are less common than all other forms; localization is usually similar to that of inverted papillomas. They consist of stratified columnar epithelial cells with granular eosinophilic cytoplasm. These tumors often recur due to incomplete primary removal. Inverted and oncocytic papillomas degenerate into squamous cell carcinoma in about 11% of cases. Exophytic papillomas rarely become malignant.
Microscopic examination of the tissues of inverted papilloma reveals the presence of multiple areas of stratified squamous epithelium,growing inside its own lamina; covering epithelium thinned, but its structure is not damaged.
According to WHO classification 2005, there are several forms of nasopharyngeal cancer:
(1) (with typical characteristics keratinizing squamous cell carcinoma);
(2) nonkeratinizing cancer, which can be differentiated (preserved intercellular bridges and clear cell boundaries) and undifferentiated (characterized by syncytial growth and the absence of clear boundaries between cells);
(3) basaloid squamous cell carcinoma (similar to tumors affecting the larynx). The mainstay of treatment is radiation therapy.
Squamous cell carcinoma of the nasal cavity and paranasal sinuses is a rare tumor, found mainly in adults, that affects maxillary sinus(60%), nasal cavity (12%), ethmoidal labyrinth (10-15%), nasal vestibule (4%), frontal and sphenoid sinuses (1% each). Metastasizes rarely, but is characterized by locally destructive growth.
a - Nonkeratinizing columnar cell carcinoma is characterized by the presence of strands of immature atypical epithelial cells (they lack keratin). Note the invasion of the mucous gland.
b - Undifferentiated cancer of the nasal cavity is an extremely aggressive malignancy with a locally disseminated pathological process,
which in most cases is not related to Epstein-Barr virus.
It is characterized by the presence of small groups, trabeculae or sheets of undifferentiated epithelial cells with a high ratio of nucleus to cytoplasm,
frequent mitoses and the presence of extensive areas of necrosis.
Even with aggressive treatment, the prognosis is poor.
Most cases diseases It is represented by simple squamous cell carcinoma with clear cell boundaries, preserved intercellular contacts, and keratin deposition in the intra- and extracellular space. Squamous cell carcinoma can be well differentiated (characterized by the formation of “epithelial pearls”), poorly differentiated (characterized by the absence of keratin), or moderately differentiated (containing some keratin).
In rare cases squamous cell carcinoma may be non-keratinizing (cylindrical cell, transitional cell). Verrucous carcinoma, basaloid squamous cell carcinoma, papillary squamous cell carcinoma, spindle cell carcinoma, and glandular squamous cell carcinoma are extremely rare.
Lymphoepithelial cancer is a rare undifferentiated form of cancer with pronounced lymphoplasmacytic infiltration. Can affect the nasal cavity and paranasal sinuses. Morphologically similar to lymphoepithelial cancer of the nasopharynx; often associated with Epstein-Barr virus. Reacts well to radiation therapy. Undifferentiated cancer of the oral cavity and paranasal sinuses is a highly malignant neoplasm that is not usually associated with Epstein-Barr virus.
For adenocarcinoma intestinal type affecting the paranasal sinuses, characterized by the presence of malignant invasive epithelium with densely grouped glands of irregular shape,
consisting of columnar epithelial cells and rare goblet cells with hyperchromic nuclei.
The inset shows the result of an immunohistochemical study for the expression of the CDX-2 marker.
Intestinal-type adenocarcinoma can affect the ethmoidal labyrinth (40%), nasal cavity (27%), and maxillary sinuses (20%).
Some of these cells histologically resemble normal intestinal structures (Paneth cells, enterochromaffin cells, villi, muscularis mucosa).
Intestinal type adenocarcinoma affects the ethmoid labyrinth (40%), nasal cavity (27%), maxillary sinus (20%).
For poorly differentiated adenocarcinoma non-intestinal origin is characterized by a glandular or papillary structure with a single layer of cuboidal epithelium; characterized by local invasion.
Papillary adenocarcinoma of the nasopharynx may have a similar morphological structure to papillary cancer thyroid gland, from which it is distinguished by a negative immunohistochemical reaction to thyroglobulin and thyroid transcription factor (TTF-1). Small cell neuroendocrine cancer is a highly differentiated malignant tumor, growing from the upper or posterior parts of the nasal cavity and spreading into the paranasal sinuses and/or nasopharynx.
Small or medium cell size forms clusters; They are characterized by a high nucleus-cytoplasm ratio, nuclear hyperchromatosis, nuclear fusion, and high mitotic activity. Immunohistochemically, the tumor is characterized by an increase in the level of neuroendocrine markers (synaptophysin, chromogranin, neuro-specific enolase) and cytokeratin. Extremely rare carcinoids of the nose and paranasal sinuses have also been described.
Olfactory neuroblastoma (eisthesioneuroblastoma) is a malignant neuroectodermal tumor originating from the olfactory layer of the upper parts of the nasal cavity with spread into the cranial cavity and/or paranasal sinuses.
Typically, tumor cells are grouped in the submucosal layer in the form of lobes or nodes that are separated by vascularized fibrous stroma.
The cells are characterized by a small amount of cytoplasm and the presence of inclusions of nuclear chromatin (“salt and pepper”).
Sometimes rosettes (pseudorosettes of Homer Wright or true Flexner-Wintersteiner rosettes), zones of necrosis, are formed.
Tumors are classified depending on differentiation, presence of nuclear pleomorphism and necrosis, and mitotic rate (patients with Hyam stage I-II have a better prognosis than Hyam III-IV).
Neuroendocrine markers are positive, cytokeratin is negative. At the periphery of tumor nodes, specific supporting cells expressing S-100 are identified.
Ectopic pituitary adenoma consists of polygonal, cytologically normal epithelial cells with clear boundaries; the degree of cytoplasmic staining may vary. Ectopic pituitary adenomas arise from embryonic remnants of the adenohypophysis in the nasopharynx or sphenoid sinus.
Polygonal epithelial cells express cytokeratin, neuroendocrine markers and specific pituitary hormones.
Olfactory neuroblastoma (esthesioneuroblastoma) is a malignant neuroectodermal tumor arising from the olfactory epithelium of the upper nasal cavity, which often extends into the cranial cavity and/or paranasal sinuses. Ectopic pituitary adenomas can arise at the site of the embryonic remnant of the adenohypophysis (in the nasopharynx or sphenoid sinus). They may contain polygonal epithelial cells containing cytokeratins, neuroendocrine markers and specific pituitary hormones.
Malignant melanoma mucous membrane is a rare tumor of the paranasal sinuses and nasal cavity that sometimes occurs in elderly patients. Like melanoma of any other localization, it easily mimics and can be represented by a variety of cells (epithelioid, spindle-shaped, plasmacytoid, rod-shaped and/or multinucleated. Specific immunohistochemical markers (S-100, HMB-45, melan-A, microphthalmia-associated transcription factor).
To other rare neuroectodermal tumors include Ewing's sarcoma, primitive neuroectodermal tumors and paragangliomas. Hemangioma is a benign vascular tumor that can be localized on the nasal septum, turbinates and paranasal sinuses; it consists of proliferating capillaries with inclusions of fibrous stroma.
Angiofibroma of the nasopharynx is characterized by irregularly shaped vascular spaces with thick walls, the stroma is collagenized, with spindle-shaped and stellate fibroblasts.
Angiofibroma of the nasopharynx occurs exclusively in young males and originates from the posterolateral wall of the nasal cavity or nasopharynx,
characterized by the presence of areas of proliferation of vascular tissue.
The vessels are thin, branching, lined with endothelium, muscle layer not always present. The probability of relapse reaches 20%.
Angiofibroma of the nasopharynx It occurs exclusively in young males and is localized on the posterolateral wall of the nasal cavity or in the nasopharynx. The risk of local relapse is quite high.
Glomangiopericytoma (hemangiopericytoma of the paranasal sinuses) affects the paranasal sinuses, characterized by a perivascular myxoid phenotype, the presence of round nuclei and irregularly shaped vessels.
It is a subepithelial non-encapsulated tumor, consisting of cells tightly fused to each other with solid,
fascicular or convoluted growth pattern, collagen fibers and frequent branching vessels.
Positive for muscle actin, vimentin, factor XIIIa; negative HaCD34, Bcl-2, CD99 (which distinguishes it from soft tissue hemangiopericytoma).
Glomangiopericytoma(hemangiopericytoma of the nasal cavity and paranasal sinuses) is a subepithelial non-encapsulated tumor consisting of cells closely adjacent to each other, growing in a solid, umbilical, curled, tortuous type; characterized by a low collagen content and the presence of branching (“coral”) vessels.
Solitary fibrous tumors in the nasal cavity rare, they are composed of intertwined fibroblasts and a dense vascular network. The cells are positive for CD34 and Bcl-2 but do not express smooth muscle actin. Germ cell tumors of the nasal cavity are rare. Mature teratomas may include mature skin, skin appendages, neuroglial tissue, smooth muscle, bone, salivary glands, respiratory and gastrointestinal epithelium. Elements of ectoderm, endoderm and mesoderm can occur in any proportion.
