PMC8025957_01
(a) Infected maxillary sinus tract opening and discharge on right side of the face. (b) Coronal view: computed tomography revealed a hypodense osteolytic space-occupying lesion with a deviation of the nasal septum. (c) Grossly, it exhibits brownish and creamish white in color. (d) In x 10 view (left), x20 view (right), epithelium exhibits a marked transition from pseudostratified ciliated columnar respiratory epithelium (blue arrow) to stratified squamous epithelium (red arrow) (e): x20 view (left) revealed a stratified squamous epithelium with lamellar sheets of keratin supraepithelially. x10 view (right) exhibits stratified squamous epithelium with inflammatory cells and blood capillaries. (f) x10 view exhibits loose sheets and flakes of dense eosinophilic, acellular, and anucleated areas resembling orthokeratin supraepithelially (g) x10 view shows squamous metaplasia and areas of hemorrhage in the fibrocollagenous connective tissue stroma (h) x20 view exhibits multinucleated giant cell in the connective tissue (i) x10 view revealed cholesterol clefts in the connective tissue stroma
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F1
On extraoral examination, there was an infected tract opening arising from the maxillary sinus [Figure 1a] with a discharge on the right side of the face near the nasolabial fold. On radiographic examination, computed tomography revealed the presence of an osteolytic lesion which was hypodense, with well-defined borders and deviation of the nasal septum [Figure 1b]. Grossly, the specimen was creamish white in color [Figure 1c] with membranous plaques and soft in consistency. Histopathologically, it revealed a marked transition from pseudostratified ciliated columnar respiratory epithelium to stratified squamous epithelium with lamellar keratin supraepithelially [Figure 1d and e]. It also exhibited alternating sheets and flakes of loose and dense eosinophilic, acellular, and anucleated areas resembling orthokeratin supraepithelially [Figure 1f] and varying degrees of squamous cell metaplasia [Figure 1g]. The connective tissue also exhibits multinucleated giant cell, few cholesterol clefts [Figure 1h and i], areas of hemorrhage, inflammatory cells, and blood capillaries interspersed with fibrocollagenous stroma.