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2016, Volume 32, Number 3, Page(s) 196-199     
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DOI: 10.5146/tjpath.2014.01255
Nasal Polyp – An Incidental Paraganglioma
Ruchi SRIVASTAVA1, Neelam WADHWA1, Shikha GUPTA2, Urvashi RAZDAN3
1Department of Pathology, University College of Medical Sciences, DELHI, INDIA
2Departments of Pathology, Jag Pravesh Chandra Hospital, DELHI, INDIA
3Departments of Otorhinolaryngology, Jag Pravesh Chandra Hospital, DELHI, INDIA
Keywords: Nose, Paraganglioma, Epistaxis, Extra-adrenal, Nasal polyp

The nose is an uncommon site for head and neck paraganglioma. The diagnosis is seldom established pre-operatively; its rarity, infrequent functionality and often benign biologic outcome underlie this fact. We present one such case in a 60-year-old man who presented with right nasal obstruction and episodic epistaxis. Rhinoscopy revealed a fleshy polypoid mass arising from the anterior cartilaginous nasal septum. Imaging studies excluded extra-nasal extension. The tumor was highly vascular showing numerous variable sized, mostly thin walled branching blood vessels akin to stag-horn shape simulating a vascular neoplasm. There were large areas of hyalinization. The typical tumor morphology was discernible only in focal areas. Immuno-histochemistry confirmed the diagnosis. The tumor cells expressed neuron specific enolase; S-100 stain demonstrated a vague zell-ballen pattern. Paraganglioma is a rare histologic diagnosis in nasal polypectomy specimen. We discuss the approach to exclude its morphologic mimics including vascular tumors.

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