PMC9860199_01
(A) Axial T1 fat saturated post-contrast magnetic resonance imaging of the face/paranasal sinuses. (B) Axial T2 fat saturated magnetic resonance imaging of the face/paranasal sinuses. (C) Coronal T1 fat saturated with gadolinium contrast magnetic resonance imaging of the face/paranasal sinuses. (D) Coronal T2 fat saturated magnetic resonance imaging of the face/paranasal sinuses. Imaging demonstrates findings of a right-sided sinonasal passageway lesion.
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T1 hypointense, heterogeneous T2, and enhancing soft tissue mass measuring approximately 6.1 x 3.1 x 4.1 cm centered within the right nasal cavity. The mass appeared to extend from the right piriform aperture to the ventral aspect of the right nasopharynx (Figure 1A,B). A craniocaudal measurement demonstrated the mass extending 4.1 cm from the floor of the right nasal cavity to the floor of right anterior cranial fossa (Figure 1C,D).
(A) Photomicrograph of hematoxylin and eosin-stained section of the tumor depicting a mixture of bland spindle-shaped myofibroblasts intermixed with collagenous stroma. Larger atypical cells demonstrate prominent nuclear pleomorphism and occasional multinucleated cells in the setting of reactivity. (B) Tumor cells are strongly positive for desmin; cytoplasmic (C) Tumor cells are strongly positive for Smooth Muscle Actin; cytoplasmic. (D) Tumor cells are focally positive for CD34 with moderate intensity; membranous.
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Histologic examination showed a well-circumscribed purely mesenchymal neoplasm that lacked a true capsule, demonstrating short to elongated spindle cells arranged in haphazard intersecting fascicles (Figure 2A). Immunohistochemical studies showed strong diffuse reactivity to SMA and desmin in the tumor cells with focal reactivity of moderate intensity for CD34 (Figure 2B-D).