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Case 4
Tumor of the nasal cavity
A. Bellomi
– Mantova Hospital
(Pictures by dr. Cassisa)
Clinical history
64 y.o. woman with recent, quickly growing formation in the nose, infiltrating the nasal osseous-cartilaginous structures. A FNA is performed ( Picture 1 - Picture 2 - Picture 3) and shows poorly differentiated epithelioid cells, forming solid nests. On an incisional biopsy a diagnosis of poorly differentiated carcinoma is done.
Macroscopical description
A 3 cm lardaceous mass.
Microscopical description
Multi-nodular tumor, which protrudes from the mucosa and infiltrates the nasal cartilage. The central portion is solid (Picture 4) with cells with scanty cytoplasm, large nucleus, marked anaplasia and numerous mitoses. There are necrotic and fibrous areas ( Picture 5 - Picture 6). The immunohistochemical staining is of no help.
At the periphery of the lesion ( Picture 7), the neoplastic cells become smaller, less atypical, forming cords and assuming characteristic and pathognomonic features ( Picture 8 - Picture 9 - Picture 10 - Picture 11).
Diagnosis
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