Nasal Tumour

Today I looked at a case of an exophytic, papillomatous nasal tumour with hyperplastic squamous epithelium which was cytologically really very bland. It was a exophytic Schneiderian papilloma which is common in the nose where there is not much opportunity for it follow a inverted growth pattern.

Schneiderian papillomas

  • Exophytic- Common. With scheiderian papillomas it is worth looking for cilia on the surface as the epithelium may be transitional between squamous and columnar. Thought to be assoc with HPV 6 & 11.
  • Inverted – Benign but locally invasive with high recurrence
  • Cylindrical – The surface epithelium shows oncocytic change with microcysts filled with neutrophils

There is a small risk of malignant transformation in inverted and cylindrical schneiderian papillomas.

Differentials include:

  • Squamous papillomas – may be keratinising
  • Squamous carcinoma – more pleomorphic, infiltrative

References:

Gattuso. Differential Diagnosis in Surgical Pathology

Robbins & Cotrans. Pathologic Basis of Disease.

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