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Clinical Challenge | Pathology

Ethmoid Sinus Mass QUIZ

Zao Yang, MD1; Ravindra Uppaluri, MD, PhD2; James S. Lewis Jr, MD2,3
[+] Author Affiliations
1Department of Otolaryngology–Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport
2Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
3Department of Pathology and Immunology, Washington University School of Medicine, St Louis, Missouri
JAMA Otolaryngol Head Neck Surg. 2015;141(4):389-390. doi:10.1001/jamaoto.2015.22.
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A man in his 50s presented with worsening sinus obstruction and congestion, more severe on the left side, with associated hyposmia, facial pressure, and frontal headaches. Computed tomography showed a 3.1-cm mass in the left ethmoid sinus and nasal cavity approaching the cribriform plate. What is the diagnosis?

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Figure.

Ethmoid sinus mass. A, Computed tomographic scan. The arrowhead indicates the mass. B, Blastema as indicated by the asterisk and malignant glands as indicated by the arrowhead. C, Rhabdomyoblasts as indicated by the arrowheads (hematoxylin-eosin, original magnification ×40). D, Desmin immunohistochemistry with strong positive staining in the rhabdomyoblasts (original magnification ×20).

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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.
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