A 26-year-old Somalian man presented with a several-year history of right-sided, progressive, obstructed nasal breathing and headache. His medical history was remarkable for the presence of asthma and a previous operation on the nasal cavity, which was performed in Somalia. The complaints of obstructed nasal breathing appeared to have been present before and continued after the surgery. Nasal endoscopy revealed a mass completely occupying the medial and superior meatus in the right nasal cavity. Additional tests, including a complete blood cell count, serologic screening for human immunodeficiency virus, and determination of immunoglobulin levels, did not reveal any immunodeficiencies. A radioallergosorbent test was positive for house dust mite (6.1 kU/L) and Aspergillus fumigatus (8.7 kU/L).
Lammers MJW, Lo Galbo AM, Buwalda J. Pathology Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2012;138(4):426. doi:10.1001/archoto.2011.1257a