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Pathology Forum
January 2001

Diagnosis Quiz Case 2

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Copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2001

Arch Otolaryngol Head Neck Surg. 2001;127(1):80-82. doi:

The mucosa of the nasal and paranasal sinuses gives rise to a spectrum of papillomatous neoplasms. Also referred to as schneiderian papillomas, they are benign neoplasms arising from the ectodermally derived sinonasal tract mucosa. They are typically divided into septal or fungiform, inverted, and cylindrical cell types, with the latter being the least common. In general, inverted papilloma usually arises from the lateral nasal wall and the paranasal sinuses, whereas the fungiform type most often occurs on the nasal septum. Cylindrical cell papilloma is characterized by a multilayered proliferation of columnar or cylindrical cells with minimal epidermoid or squamous cell components.1 The cylindrical cell papilloma may exhibit inverting and exophytic components, and its anatomical distribution and clinical behavior parallel those of the inverted type. The consistent identification of microscopic mucous cysts interspersed throughout the neoplastic epithelium is one histologic characteristic that differentiates papillomas of the nasal cavity and paranasal sinuses from papillomas arising from stratified squamous epithelial cells elsewhere in the body. The histologic sections in Figure 1 are from a schneiderian-type papilloma and are characteristic of its biphasic pattern of squamous epithelium (arrowheads) adjacent to respiratory epithelium (arrows) at low power (A, original magnification ×40), at high power (B, original magnification ×400), and with mucicarmine stain accentuating the respiratory mucosa (C).

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