PMC6304863_01
Axial CT image showing a soft tissue mass centered at the posterior nasal septum with extension into the nasopharynx.
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Preoperative CT imaging showed a smoothly marginated, soft tissue density mass centered at the posterior nasal septum with extension into the nasopharynx and bulging into the right sphenoid sinus (Figure 1).
Intraoperative image of the mass protruding from the posterior septum within the left nasal cavity.
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Intraoperatively, a large mass was seen in the posterior aspect of the septum, bulging into the bilateral nasal cavities and extending into the sphenoid sinuses (Figure 2).
(a) H&E of the septal mass showing a "zellballen" pattern of clusters of epithelioid cells between bands of fibrillary stroma (20x). IHC staining showing positivity for (b) chromogranin A within epithelioid cells (40x), (c) synaptophysin within epithelioid cells (20x), and (d) S-100 within fibrillary cells (20x).
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Postoperative histologic analysis of the specimen was consistent with a paraganglioma (Figure 3).