schneiderian papilloma


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  • Clinical

    • male > female (inverted and exophytic)
    • age 40-70, uncommon in children (inverted, oncocytic)
    • age 20-50 (exophytic)
    • location
      • lateral nasal wall (inverted, oncocytic)
      • septum (exophytic)
      • sinuses
      • can extend into adjacent structures
    • nasal obstruction, epistaxis
    • HPV association (inverted, exophytic)

  • Histology

  • Pearls

    • r/o carcinoma component

  • Stains

    • CK+
    • CD44+ (vs decreased in carcinoma)

  • Ddx

    • inverted type
      • nasal polyp with squamous metaplasia
        • prominent normal seromucinous glands
        • thick hyalinized basement membrane
        • stromal inflammation
      • REAH
        • posterior nasal septum
        • glands lined by respiratory epithelium
        • thick hyalinized basement membrane
    • oncocytic
      • rhinosporidiosis
        • involves stroma in addition to epithelium
      • low grade papillary adenocarcinoma
        • invasion, lack intact basement membrane
        • lacks intraepithelial microcysts
    • exophytic
      • squamous papilloma
        • keratinized
        • lacks intraepithelial microcysts
    • papillary SCC
    		•