Head Neck Pathol Radiology Pathology Classics

Excerpt

Sinonasal Schneiderian papillomas (SSP) are benign neoplasms arising primarily in the nasal cavity but they may also arise in the paranasal sinuses. These papillomas arise from the Schneiderian mucosa which lines the nasal cavity and paranasal sinuses. Schneiderian mucosa is of ectodermal derivation in contrast to the mucosal lining of the nasopharynx which is endodermally derived. Three variants of SSP are classically described: (1) exophytic/fungiform, (2) inverted and (3) cylindrical cell. The variants are defined by location (septal, lateral nasal wall), gross/endoscopic appearance and histologic features. Overall, however, the clinical features and biologic behavior are similar. They occur over a wide age range but in general are not common in children. Symptoms vary and are dependent on location. They may include nasal obstruction, epistaxis, rhinorrhea, pain (i.e., headaches) and the presence of a “mass” lesion. There is some evidence suggesting a relationship to human papilloma virus (HPV) infection. HPV types 6 and 11 (low risk type) have been most commonly identified using in situ hybridization (ISH) or polymerase chain reaction (PCR) techniques; HPV-types 16, 18 have been identified rarely. The presence of HPV does not appear to increase the risk of malignant transformation, at least in the current studies available. …