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:

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)