Date of Presentation:1/29/2022

Attending pathologist: Paul Wakely, MD

Presented by: Saba Shafi, MD

Prepared by: Saba Shafi, MD

Organ:Nose

HISTORY:

A 29-year-old female with nasal congestion, rhinorrhea, paroxysmal nocturnal dyspnea, tenderness of maxillary region for two years and had a recent exacerbation of 2-3 months of sinus infection. Had a CT scan which demonstrated mucosal thickening, deviated septum, and nasal polyps. C-ANCA is negative. Underwent septoplasty, inferior turbinate reduction, ESS (frontal, sphenoid, maxillary, ethmoid), nasal polyp removal. The nasal biopsy is as follows.

GROSS:

Microscopic image possibly detecting cancerous areas in human tissue

What is the most likely diagnosis?

  1. Sinonasal polyp, inverted type
  2. Allergic granulomatosis
  3. Allergic fungal sinusitis
  4. Granulomatosis with polyangiitis (consistent with clinical H/O Wegener’s)
Granulomatosis with polyangiitis (consistent with clinical H/O Wegener’s)

CASE SUMMARY