Case 310 -- A Nasal Mass

Contributed by Zhengbin Lu, MD
Published on line in June 2002


PATIENT HISTORY:

A 51 year-old woman with history of ductal carcinoma in-situ of breast, status post of mastectomy, polycythemia vera and enlarged spleen presented with a nasal mass. The biopsy of the nasal mass was performed. The case was sent to us for a consultation.

MICROSCOPIC DESCRIPTION:

The H&E sections of the nasal mass demonstrate highly ulcerated mucosa with prominent pseudoepitheliomatous hyperplasia and a polymorphous infiltrate composed of atypical lymphocytes and inflammatory cells (Figs. 01 and 02). Extensive submucosal coagulative necrosis is also present (Figs. 03 and 04). The tumor cells are composed of predominant intermediate-sized to large cells with irregular, sometimes elongated nuclei, inconspicuous nucleoli and small to moderate amount of cytoplasm (Figs. 05 and 06). A focus of probable angiocentric/angiodestructive infiltrate is seen (Fig. 07). Intimately admixed are plasma cells, small lymphocytes and eosinophils (Figs 05, 06 and 07).

IMMUNOHISTOCHEMISTRY:

CD2 + CD3 (cytoplasmic) + CD4 - CD5 -
CD7 + CD8 + CD20 - CD56 +
 
TIA-1 + TCR beta - EBV (EBER/ISH) +  


FINAL DIAGNOSIS


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