PMC9619332_01
Axial pre- and post-contrast computed tomography (CT) images. Pre-contrast CT scans on the bone window (A) and the soft-tissue window (C) demonstrated a paranasal lesion with a thick capsule and multiple internal "ground-glass" nodules (arrows). Central hypodensity (*) and a well-defined margin were noticed (open arrows). Post-contrast CT scans on the bone window (B) and the soft tissue window (D) showed no enhancement.
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Pre- and post-contrast CT images (Fig. 1) revealed a 76 x 60 x 57 mm mass that originated in the left maxillary sinus and spread upward into the ethmoid and bilateral frontal sinuses.
Pre- and post-gadolinium magnetic resonance imaging (MRI). (A) Coronal T2-weighted (T2W), (C) sagittal T1-weighted (T1W), and (E) axial fluid-attenuated inversion recovery sequences demonstrated a paranasal mass with a hypointense cortical area (arrows) and a fluidized, hyperintense center area (*). A well-defined margin with an adjacent bone structure and soft tissue were also noted. (B) Post-gadolinium coronal T1W, (D) post-gadolinium sagittal T1W, and (F) post-gadolinium axial T1W sequences demonstrated ring-like and septal enhancement. G) Axial diffusion-weighted imaging and (H) axial apparent diffusion coefficient showed no restricted diffusion.
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Microscopic histopathologic images. (A) A 10x magnification image showed large cytoplasmic spindle cells arranged in rafts with interspersed psammomatoid bodies interspersed (arrows). (B) A 40x magnification image showing psammomatoid bodies (arrows).
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On microscopic examination (Fig. 3), this neoplasm consisted of large cytoplasmic spindle cells arranged in rafts with interspersed psammomatoid bodies.
Post-surgical computed tomography (CT) images. (A) Bone window and (B) soft tissue window showed significant size reductions, correlated with clinical symptom relief.
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Post-surgical CT imaging (Fig. 4) revealed "ground-glass" in the lesion cortex, suggesting residual lesions after surgery.