PMC6572921_01
Right parotid fistula and nasal saddling.
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The right parotid was tender with pus-draining sinus ( Figure 1 ). Examination of the external nose demonstrated supratip nasal depression (saddling) ( Figure 1 ).
An area of heavy inflammatory infiltrate including a larger blood vessel (BV) with acute inflammatory cells in the wall (arrows) (hematoxylin and eosin, x200).
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Histopathological assessment of nasal biopsy revealed heavy chronic lymphoplasmacytic granulation tissue with granulomatoid lesions, vasculitis, and superadded heavy suppurative necrosis, featuring GPA ( Figures 2  and  3 ).
Chronic inflammatory cells, mainly lymphocytes and plasma cells, among compressed blood vessels (asterisk) (hematoxylin and eosin, x200).
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Histopathological assessment of nasal biopsy revealed heavy chronic lymphoplasmacytic granulation tissue with granulomatoid lesions, vasculitis, and superadded heavy suppurative necrosis, featuring GPA ( Figures 2  and  3 ).