Indranil Pal1, Amlan Gupta, Subhabrata Sengupta. 1. Department of Ear Nose Throat and Head and Neck Surgery, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India.
Abstract
OBJECTIVES: To present a case of sino-nasal destructive mass initially diagnosed as an inflammatory lesion following punch biopsy from the lesion however the post surgical histopathology was diagnostic of Grade 2 angiocentric immunoproliferative lesion (AIL). The reasons for the initial misdiagnosis are analyzed. MATERIALS AND METHODS: A 76-year-old male patient presenting with progressive bilateral nasal obstruction for 1 year. Repeated punch biopsies from the mass were suggestive of an inflammatory lesion. RESULT: The patient underwent surgical exenteration of the mass and the final histopathology report suggested AIL Grade 2. The patient was thereafter treated with chemotherapy and radiotherapy. CONCLUSION: Initial superficial punch biopsies lead to incorrect diagnosis leading to an unnecessary surgical exenteration. The explanations for the initial misdiagnosis are given below and appropriate diagnostic protocols, mode and depth of biopsy are suggested based on the case study.
OBJECTIVES: To present a case of sino-nasal destructive mass initially diagnosed as an inflammatory lesion following punch biopsy from the lesion however the post surgical histopathology was diagnostic of Grade 2 angiocentric immunoproliferative lesion (AIL). The reasons for the initial misdiagnosis are analyzed. MATERIALS AND METHODS: A 76-year-old male patient presenting with progressive bilateral nasal obstruction for 1 year. Repeated punch biopsies from the mass were suggestive of an inflammatory lesion. RESULT: The patient underwent surgical exenteration of the mass and the final histopathology report suggested AIL Grade 2. The patient was thereafter treated with chemotherapy and radiotherapy. CONCLUSION: Initial superficial punch biopsies lead to incorrect diagnosis leading to an unnecessary surgical exenteration. The explanations for the initial misdiagnosis are given below and appropriate diagnostic protocols, mode and depth of biopsy are suggested based on the case study.
Authors: N Fujima; Y Nakamaru; T Sakashita; A Homma; A Tsukahara; K Kudo; H Shirato Journal: Dentomaxillofac Radiol Date: 2015-06-09 Impact factor: 2.419