PMC4073472_01
Extraoral photograph showing diffuse swelling on left middle third of face extending antero-posteriorly from 1 cm lateral to left ala of the nose till anterior to the tragus of the left ear and supero-inferiorly from left infra-orbital margin to the left corner of mouth
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F1
The swelling was initially small in size and has increased to the present size over a period of 1 month [Figure 1]. It measured 3 cm x 3 cm in size and extends antero-posteriorly from 1 cm lateral to left ala of the nose until anterior to the tragus of the left ear and supero-inferiorly from left infra-orbital margin to the left corner of mouth [Figure 1].
Intraoral photograph showing single ill-defined, diffuse swelling on left buccal side of maxilla slight obliteration of vestibule along with expansion of buccal and palatal cortical bone
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F2
Overlying mucosa was normal with no ulceration [Figure 2].
Orthopantomograph showing haziness in left maxillary sinus and is more radiopaque as compared to contralateral sinus
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F3
Orthopantomograph (OPG) revealed a marked area of haziness in left maxillary sinus and is more radio-opaque than contralateral sinus [Figure 3].
X-ray Water's view, demonstrating haziness in left maxillary sinus with more radiopacity than contralateral sinus
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F4
X-ray water's view, reconfirmed the findings as observed in OPG [Figure 4].
Computed tomography scan revealing the extent of lesion which extends superiorly to infra-orbital margin medially nasal cavity and inferiorly to maxillary alveolar ridge and laterally expansion of zygoma
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F5
It extends superiorly to infra-orbital margin medially to nasal cavity and inferiorly to maxillary alveolar ridge and laterally expansion of zygoma [Figure 5].
Diffuse monotonous infiltrate of medium sized or large cells, with interspersed eosinophillic cells (H and E, x40)
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F6
Most of the atypical myeloid cells showed increased nucleo-cytoplasmic ratio with round to ovoid, vesicular, reniform, or multilobated nuclei and finely granular eosinophillic cytoplasm [Figures 6 and 7].
Myeloid atypical cells showing eosinophillic cytoplasm with fine granularity (H and E, x40)
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F7
Most of the atypical myeloid cells showed increased nucleo-cytoplasmic ratio with round to ovoid, vesicular, reniform, or multilobated nuclei and finely granular eosinophillic cytoplasm [Figures 6 and 7].
Immunohistochemical stained hotomicrograph showing CD99 positive cells (x40)
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F8
Positive reactivity was observed with CD99 [Figure 8], vimentin [Figure 9], CD31 [Figure 10], myeloperoxidase (MPO) [Figure 11], whereas Desmin, Actin, epithelial membrane antigen [Figure 12], synaptophysin [Figure 13], leukocyte-common antigen (LCA) and CD20 [Figure 14] showed a negative staining.
Photomicrograph showing Vimentin positive cells (x40)
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F9
Positive reactivity was observed with CD99 [Figure 8], vimentin [Figure 9], CD31 [Figure 10], myeloperoxidase (MPO) [Figure 11], whereas Desmin, Actin, epithelial membrane antigen [Figure 12], synaptophysin [Figure 13], leukocyte-common antigen (LCA) and CD20 [Figure 14] showed a negative staining.
Immunohistochemical stained photomicrograph showing CD31 positive cells (x40)
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F10
Positive reactivity was observed with CD99 [Figure 8], vimentin [Figure 9], CD31 [Figure 10], myeloperoxidase (MPO) [Figure 11], whereas Desmin, Actin, epithelial membrane antigen [Figure 12], synaptophysin [Figure 13], leukocyte-common antigen (LCA) and CD20 [Figure 14] showed a negative staining.
Immunohistochemical stained photomicrograph showing myeloperoxidase positive cells (x40)
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F11
Positive reactivity was observed with CD99 [Figure 8], vimentin [Figure 9], CD31 [Figure 10], myeloperoxidase (MPO) [Figure 11], whereas Desmin, Actin, epithelial membrane antigen [Figure 12], synaptophysin [Figure 13], leukocyte-common antigen (LCA) and CD20 [Figure 14] showed a negative staining.
Immunohistochemical stained photomicrograph showing epithelial membrane antigen negative cells (x40)
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F12
Positive reactivity was observed with CD99 [Figure 8], vimentin [Figure 9], CD31 [Figure 10], myeloperoxidase (MPO) [Figure 11], whereas Desmin, Actin, epithelial membrane antigen [Figure 12], synaptophysin [Figure 13], leukocyte-common antigen (LCA) and CD20 [Figure 14] showed a negative staining.
Immunohistochemical stained photomicrograph showing negative staining for synaptophysin marker (x40)
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F13
Positive reactivity was observed with CD99 [Figure 8], vimentin [Figure 9], CD31 [Figure 10], myeloperoxidase (MPO) [Figure 11], whereas Desmin, Actin, epithelial membrane antigen [Figure 12], synaptophysin [Figure 13], leukocyte-common antigen (LCA) and CD20 [Figure 14] showed a negative staining.
Immunohistochemical stained photomicrograph showing negative staining for CD20 marker (x40)
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F14
Positive reactivity was observed with CD99 [Figure 8], vimentin [Figure 9], CD31 [Figure 10], myeloperoxidase (MPO) [Figure 11], whereas Desmin, Actin, epithelial membrane antigen [Figure 12], synaptophysin [Figure 13], leukocyte-common antigen (LCA) and CD20 [Figure 14] showed a negative staining.
Postoperative photograph showing complete remission of disease
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F15
A complete remission of the disease, with the disappearance of the swelling was observed [Figure 15].