Distinguishing Inverted Sinonasal Papilloma and Respiratory Epithelial Adenomatoid Hamartoma: A Single Institution Case Series.
Austin R Swisher, Samuel E Razmi, Michael T Sramek et al.
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Case in brief
Four patients presented with sinonasal masses initially suspected to be inverted sinonasal papilloma (ISP) based on intraoperative frozen sections. However, permanent pathology confirmed the diagnosis of respiratory epithelial adenomatoid hamartoma (REAH). Histological analysis revealed key differences, with REAH showing ciliated glandular proliferation, while ISP exhibited hyperplastic epithelium. Accurate diagnosis is crucial due to differing management strategies.
Diagnostic / clinical pearl
Epithelial thickness is a critical histological feature that can help differentiate between inverted sinonasal papilloma and respiratory epithelial adenomatoid hamartoma.
Why it matters
This case highlights the diagnostic challenges posed by small biopsies and frozen sections, emphasizing the need for permanent specimens and collaboration with experienced pathologists.