nose pathology

nose

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Normal

vestibule: squamous with adnexa (sebaceous, sweat glands, hair)
nasal cavity: respiratory mucosa, seromucinous glands
sinus: thin respiratory mucosa
septum: cartilage anterior, bone posterior
turbinates: respiratory mucosa, prominent vessels, bone
olfactory mucosa: respiratory epithelium and neural cells

Non-neoplastic

rhinosinusitis
infections
- mycetoma
- fungal sinusitis
  - allergic fungal sinusitis
  - invasive fungal sinusitis
  - aspergillus
  - mucor
- rhinoscleroma
- rhinosporidiosis
sinonasal polyp
vasculitis
- Wegener granulomatosis
- Churg-Strauss syndrome
other
- nasal glial heterotopia
- myospherulosis
- ectopic pituitary adenoma

WHO neoplasms

malignant epithelial
- SCC
- lymphoepithelial carcinoma
- undifferentiated carcinoma
- adenocarcinoma
  - intestinal type adenocarcinoma
  - nonintestinal type adenocarcinoma
- salivary gland type carcinoma
benign epithelial
- schneiderian papilloma
- REAH
- salivary gland type adenoma
  - pleomorphic adenoma
  - myoepithelioma
  - oncocytoma
neuroendocrine
- carcinoid
- small cell carcinoma
neuroectodermal
- PNET
- olfactory neuroblastoma
- MNTI
- melanoma
- glioma
- ectopic pituitary adenoma
soft tissue
- malignant
  - fibrosarcoma
  - MFH
  - leiomyosarcoma
  - rhabdomyosarcoma
  - angiosarcoma
  - MPNST
- borderline
  - fibromatosis
  - inflammatory myofibroblastic tumor
  - glomangiopericytoma
  - solitary fibrous tumor
- benign
  - myxoma
  - leiomyoma
  - lobular capillary hemangioma
  - schwannoma
  - neurofibroma
  - meningioma
bone and cartilage
- malignant
  - chondrosarcoma
  - osteosarcoma
  - chordoma
- benign
  - fibrous dysplasia
  - giant cell tumor
  - giant cell lesion
  - chondroma
  - osteoma
  - chondroblastoma
  - chondromyxoid fibroma
  - osteochondroma
  - osteoid osteoma
  - osteoblastoma
  - ameloblastoma
  - chondromesenchymal hamartoma
hematolymphoid
- lymphoma
  - T-cell
  - DLBCL
- plasmacytoma
- myeloid sarcoma
- histiocytic sarcoma
- langerhans cell histiocytosis
- juvenile xanthogranuloma
- Rosai Dorfman disease
GCT
- teratoma
  - mature
  - immature
  - with malignant transformation
- yolk sac tumor
- teratocarcinosarcoma
- dermoid cyst
metastasis

TNM (useful for grossing)

maxillary sinus
- T1: mucosa only
- T2: involves bone, hard palate, middle nasal meatus
- T3: involves bone of posterior maxillary sinus, subcutaneous tissue, floor or medial wall of orbit, pterygoid fossa, ethmoid sinus
- T4a: involves anterior orbital contents, skin, pterygoid plates, infratemporal fossa, cribriform plate, sphenoid, frontal sinus
- T4b: involves orbital apex, dura, brain, middle cranial fossa, cranial nerves other than V2, nasopharynx, clivus
nasal cavity, ethmoid sinus
- T1: one subsite
- T2: two subsites
- T3: involves medial wall or floor of orbit, maxillary sinus, palate, cribriform plate
- T4a: involves anterior orbital contents, skin, anterior cranial fossa, pterygoid plates, sphenoid, frontal sinus
- T4b: involves orbital apex, dura, brain, middle cranial fossa, cranial nerves other than V2, nasopharynx, clivus
- subsites: maxillary sinus, septum, floor, lateral wall, vestibule, ethmoid sinus
N
- N1: single ipsilateral node, <= 3cm
- N2a: single ipsilateral node, 3-6cm
- N2b: multiple ipsilateral nodes, <= 6cm
- N2c: contralateral or bilateral node, <= 6cm
- N3: > 6cm
- midline is considered ipsilateral

Staging

0: Tis
I: T1
II: T2
III
- T1-2, N1
- T3, N0-1
IVA: T4a or N2
IVB: T4b or N3
IVC: M1