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Sclerosing polycystic adenosis of the nasal septum: the risk of misdiagnosis.

Park IH, Hong SM, Choi H, Chang H, Lee HM - Clin Exp Otorhinolaryngol (2011)

Bottom Line: Although atypia ranging from mild dysplasia to carcinoma in situ can occur in some cases, SPA has a favorable outcome.It is important to be familiar with SPA to avoid aggresive treatment that results from a misdiagnosis.We present a case of a 49-year-old man who had 1-year history of right nasal obstruction.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea.

ABSTRACT
Sclerosing polycyctic adenosis (SPA) is a rare lesion of unknown etiology morphologically resembling fibrocystic changes of the breast. To date, approximately 41 cases of SPA have been reported. Most cases of SPA have originated in the parotid and submandibular glands, with a few cases of intra-oral minor salivary gland origin. This is the first reported case of sclerosing polycystic adenosis of nasal minor salivary gland origin. The differential diagnosis of SPA includes polycystic disease, sclerosing sialadenitis, and benign and malignant glandular neoplasias. Although atypia ranging from mild dysplasia to carcinoma in situ can occur in some cases, SPA has a favorable outcome. It is important to be familiar with SPA to avoid aggresive treatment that results from a misdiagnosis. We present a case of a 49-year-old man who had 1-year history of right nasal obstruction.

No MeSH data available.


Related in: MedlinePlus

(A) Immunohistochemical staining for smooth muscle actin demonstrated myoepithelial cells surrounding ductal epithelium (H&E, ×100). (B) Focal ductal epithelial cells showed immunoreactivity for estrogen receptor (H&E, ×400).
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Figure 4: (A) Immunohistochemical staining for smooth muscle actin demonstrated myoepithelial cells surrounding ductal epithelium (H&E, ×100). (B) Focal ductal epithelial cells showed immunoreactivity for estrogen receptor (H&E, ×400).

Mentions: Grossly, the tumor was a firm pedunculated mass, measuring 2.1×1.5×1.1 cm, with a peduncle 4 mm in length. The cut surface was lobular and glistening, containing a few tiny visible cysts <1 mm in diameter. The microscopic examination revealed a subtle lobular proliferation of dilated ductal components with cystic changes surrounded by abundant dense hyalinized hypocellular collagen stroma with a mild inflammatory cell infiltration. The ductal epithelial cells were flattened and cuboidal without atypical features. Frequent apocrine metaplasia was noted (Fig. 3). Immunohistochemical staining for α-smooth muscle actin demonstrated myoepithelial cells surrounding ductal epithelium and the epithelial cells lining ducts showed focal immunoreactivity for estrogen receptor (Fig. 4). Together, these findings were characteristic histopathologic features of SPA. The patient was discharged the next day, and the postoperative course was uneventful.


Sclerosing polycystic adenosis of the nasal septum: the risk of misdiagnosis.

Park IH, Hong SM, Choi H, Chang H, Lee HM - Clin Exp Otorhinolaryngol (2011)

(A) Immunohistochemical staining for smooth muscle actin demonstrated myoepithelial cells surrounding ductal epithelium (H&E, ×100). (B) Focal ductal epithelial cells showed immunoreactivity for estrogen receptor (H&E, ×400).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3687059&req=5

Figure 4: (A) Immunohistochemical staining for smooth muscle actin demonstrated myoepithelial cells surrounding ductal epithelium (H&E, ×100). (B) Focal ductal epithelial cells showed immunoreactivity for estrogen receptor (H&E, ×400).
Mentions: Grossly, the tumor was a firm pedunculated mass, measuring 2.1×1.5×1.1 cm, with a peduncle 4 mm in length. The cut surface was lobular and glistening, containing a few tiny visible cysts <1 mm in diameter. The microscopic examination revealed a subtle lobular proliferation of dilated ductal components with cystic changes surrounded by abundant dense hyalinized hypocellular collagen stroma with a mild inflammatory cell infiltration. The ductal epithelial cells were flattened and cuboidal without atypical features. Frequent apocrine metaplasia was noted (Fig. 3). Immunohistochemical staining for α-smooth muscle actin demonstrated myoepithelial cells surrounding ductal epithelium and the epithelial cells lining ducts showed focal immunoreactivity for estrogen receptor (Fig. 4). Together, these findings were characteristic histopathologic features of SPA. The patient was discharged the next day, and the postoperative course was uneventful.

Bottom Line: Although atypia ranging from mild dysplasia to carcinoma in situ can occur in some cases, SPA has a favorable outcome.It is important to be familiar with SPA to avoid aggresive treatment that results from a misdiagnosis.We present a case of a 49-year-old man who had 1-year history of right nasal obstruction.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea.

ABSTRACT
Sclerosing polycyctic adenosis (SPA) is a rare lesion of unknown etiology morphologically resembling fibrocystic changes of the breast. To date, approximately 41 cases of SPA have been reported. Most cases of SPA have originated in the parotid and submandibular glands, with a few cases of intra-oral minor salivary gland origin. This is the first reported case of sclerosing polycystic adenosis of nasal minor salivary gland origin. The differential diagnosis of SPA includes polycystic disease, sclerosing sialadenitis, and benign and malignant glandular neoplasias. Although atypia ranging from mild dysplasia to carcinoma in situ can occur in some cases, SPA has a favorable outcome. It is important to be familiar with SPA to avoid aggresive treatment that results from a misdiagnosis. We present a case of a 49-year-old man who had 1-year history of right nasal obstruction.

No MeSH data available.


Related in: MedlinePlus