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Table 2 The results of rhinoscopy and nasal endoscopy , surgery ,CT findings and pathology

From: Computed tomography and pathological findings of five nasal neurilemmomas

Pt rhinoscopy and nasal endoscopy Findings during surgery CT findings pathology
1 A smooth mass in right nasal vestibule and diffuse swelling of right nasal alar and also left deviation of the columella. The tumor was tough and painless. The tumor was completely removed via a gingivobuccal incision under local anesthesia. The tumor at right nasal vestibule was firm, ovoid, smooth, encapsulated. CT imaging revealed that a well-defined ovoid soft tissue mass without central in the right nasal vestibule. The mass of density was uneven. The mass had an attenuation number of 17Hounsfield units (Hu) to 43Hu.On contrast CT, there was mild enhancement(20Hu~50Hu) The nasal sinuses were clear (Figure 1). Grossly, the tumor was round, smooth, encapsulated. On cut surface, the mass was grayish, spiral and some areas was cystic. Microscopically, the tumor cells were composed of spindle cells arranged in fascicles. The tumor cells had a wavy shape, poorly defined cytoplasm, and oval nuclei with tapering ends. S-100 positive (Figure 2).
2 A firm, fixed oval mass about 1.8 cm × 1.5 cm × 1.0 cm in infer-internal of left nasal vestibule, very close to the nasal valve angle and columella was deviated to right. The tumor was completely removed via a gingivobuccal incision under local anesthesia. The mass at left nasal vestibule was firm, round, smooth, encapsulated. CT imaging showed that a well-defined round soft tissue mass without central in the right nasal vestibule. The mass of density was uneven(20 ~ 36Hu). There was patchy enhancement on contrast CT. The nasal sinuses were clear (Figure 3). Grossly, the tumor was round, smooth, encapsulated. On cut surface, the mass was grayish, spiral and some areas was cystic. Microscopically, the tumor cells were composed of spindle cells arranged in fascicles with some thickened hyalinized vessels. No evidence of vascular thrombosis was observed. S-100 positive.
3 The left nasal cavity was full of lobular, light yellow mass with yellowish bleeding secretion on the surface. The nasal septum was deviated to right and was adhesion to the right inferior turbinate. A 5.0cm × 6.0cm tumor was completely removed via lateral rhinotomy. Its pedicle was attached to the nasal septum. The external lateral wall of the left nasal was partial absorbed and the left maxillary sinus was involved. CT scan showed that a well-defined large expansile soft-tissue mass in the left nasal cavity from choana to the inferior turbinate, which extended up to the left maxillary sinus with evidence of bony dehiscence of the internal lateral wall. The nasal septum was deviated to right. There was patchy enhancement after iodinated contrast administration, which CT value was 20Hu-41.2Hu. In addition, soft tissue density was noted in the left ethmoid sinus, compatible with sinusitis due to obstruction of the sinus orifice by the mass (Figure 4). Grossly, the tumor was irregular, soft, unencapsulated. On cut surface, the mass was composed of gray firm tissue with a large central cystic space with yellow colored inner surface. Microscopically, A spindle cell neoplasm, with hypercellular areas and edematous hypocellular areas. Palisading nuclei consistent with Verocay bodies. S-100 strong positive.
4 A smooth tumor about 3.0 cm × 2.0cm located at the posterior left surface of nasal septum. The nasal common meatus had some pink nasal discharge. A3.0cm × 2.0cm tumor was completely removed via lateral rhinotomy. The mass was limit to the left nasal cavity and from nasal septum. CT scanning showed a 2.0 cm in diameter soft density mass that filling the left choana and extended into the nasopharynx. The partial bone of the nasal septum was absorbed. The left maxillary had soft tissue density compatible with sinusitis due to obstruction of the sinus orifice by the mass. CT with contrast injection showed that the mass enhanceing inhomogeneously (Figure 5). On gross examination, the mass was encapsulated. It measured 3.0cm ×  2.0cm × 2.1cm, and it had a rubbery consistency. Microscopic examination revealed spindle cells with indistinct cell outlines and a moderate amount of cytoplasm. S-100 protein immunostaining was positive.
5 A smooth, pedunculated, gray mass covering with blood crust was in the top of left surface of nasal septum. Endoscopic sinus surgery was carried out. The mass was about 1.0cm × 1.0cm in the anterior top of the left septum. The tumor excised completely with a safemargin of surrounding normal septal mucoperiosteum. A well-defined, inhomogeneous, 1.0 cm × 1.0cm soft mass that located at the anterior of the left nasal vestibule was observed by CT scan. The mass had an attenuation number of 17 (Hu). The bilateral frontal, sphenoid nasal sinuses were clear and the bilateral maxillary and ethmoid sinuses were lower density due to obstruction of the sinus orifice by the mass. There was homogeneous enhancement on contrast CT(50Hu) (Figure 6). Grossly, the tumor was round, smooth, encapsulated. On cut surface, the mass was grayish, spiral and some areas was cystic. A Pathological examination shows high cellular density and palisading pattern.The tumor cells are immunoreactive for S-100 protein.