Clinical Problem Solving: Pathology |

Pathology Quiz Case 3

Gavriel David Kohlberg, MD; Theresa Scognamiglio, MD; William Reisacher, MD
JAMA Otolaryngol Head Neck Surg. 2013;139(4):427. doi:10.1001/jamaoto.2013.283a.
Text Size: A A A
Published online


A 26-year-old Lebanese woman presented with a 3-year history of progressive right nasal obstruction along with recurring episodes of bilateral rhinorrhea and facial pressure, not relieved by antibiotics and nasal steroids. She denied fevers. The physical examination was significant for a leftward deviated septum, hypertrophy of the inferior turbinates, and a bulging pink mass, approximately 1 cm in diameter, in the right anterior nasal cavity adjacent to the nasal septum. Non–contrast-enhanced computed tomographic (CT) scans of the paranasal sinuses showed an ill-defined mass in the region of the right internal nasal valve along with moderate mucosal thickening in the left frontal, ethmoid, and maxillary sinuses, left osteomeatal complex obstruction, and left frontoethmoidal recess obstruction. The patient underwent resection of a right nasal septum mass via endonasal approach, left maxillary antrostomy, left anterior ethmoidectomy, and bilateral inferior turbinate reduction using a microdebrider. A histologic examination of the septal mass (Figure 1) demonstrated a tumor with a predominant epithelial component with chondromyxoid and ductal structures (Figure 2) showing extensive squamous metaplasia (Figure 3). There was no significant atypia, mitotic activity, or necrosis.

Figures in this Article



Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Graphic Jump Location

Figure 1.

Place holder to copy figure label and caption
Graphic Jump Location

Figure 2.

Place holder to copy figure label and caption
Graphic Jump Location

Figure 3.




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles