PMC8565585_01
Image A representing the Endoscopic view of left vascularized sinonasal mass occupying the whole of left nasal vestibule. Image B representing the left nasal cavity after the mass was removed.
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F1
On examination, rigid nasal endoscopy showed a left -sided vascularized sinonasal mass (Figure 1), that was hard in consistency and completely obstructed the left nasal vestibule.
CT images of A-Axial view CT Paranasal sinus showing a left sided nasal mass. Note the posteromedial defect of the nasolacrimal duct. B-Coronal view of paranasal sinus, demonstrating a left nasal mass extending to the nasolacrimal duct.
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F2
The clinical findings were suspicious of malignancy, therefore we proceeded with a computed tomography (CT) scan of the paranasal sinus, which showed a hypodense mass on the left anterior ethmoid sinus encasing the distal septum measuring (3.7 (AP) x 1.8 (W) x 2.4 (CC) (Figure 2), with right maxillary sinus thickening and enlarged level 1b cervical lymph node measuring 1.1 cm, and well-pneumatized bilateral frontal, sphenoid and mastoid air cells. At six-month follow up, there was no local recurrence on repeated nasal endoscopies (Figure 2) and she has achieved complete remission.
Histopathologic samples from tumour. Image A representing tissue with CD68. Image B representing tissue with Mason Trichome stain showing characteristic storiform pattern fibrosis. Image C representing S100 stain showing emperipolesis.
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F3
The histopathological examination of the left nasal mass (Figure 3) showed fibro-inflammatory lesion that consisted of lymphohistiocytic infiltrates with background of vague storiform-like pattern fibrosis (highlighted by Mason trichrome stain), and the presence of emperipolesis (highlighted by immunohistochemical S100, CD 68 stains).