title: Low-Grade Epithelial Proliferations of the Sinonasal Tract.
abstract: Low-grade epithelial proliferations of the sinonasal tract include Schneiderian papillomas, respiratory epithelial adenomatoid hamartoma, seromucinous hamartoma and low-grade non-intestinal adenocarcinoma. There is considerable overlap in their clinical presentation, endoscopic appearance, and imaging features. Although well-described diagnostic criteria exist, a definitive diagnosis may be difficult to reach on a small biopsy. Schneiderian papillomas are divided into fungiform, inverted, and oncocytic types, each with characteristic clinical and morphological features. The latter two may progress to malignancy. The majority are still considered to be HPV-related. Two lesions are designated as hamartomas, but their pathogenesis remains uncertain, with inflammatory and neoplastic origins proposed. Respiratory epithelial adenomatoid hamartoma is increasingly being recognized for its association with chronic rhinosinusitis and olfactory cleft site of origin. Seromucinous hamartoma has gained attention in recent years and overlaps with both respiratory epithelial adenomatoid hamartoma and low-grade non-intestinal adenocarcinoma. Controversy surrounds their distinction, particularly from low-grade adenocarcinoma. The latter generally is cured by complete excision, with a 26 % risk of recurrence but rare metastases and deaths from disease.
authors.affiliation: Departments of Pathology and Surgery, Dalhousie University, Halifax, NS, Canada. martin.bullockmd@nshealth.ca.|Division of Anatomical Pathology, Queen Elizabeth II Health Sciences Centre (QEII HSC), 716-5788 University Avenue, Halifax, NS, B3H 1V8, Canada. martin.bullockmd@nshealth.ca.
authors.forename: Martin J
authors.identifier: http://orcid.org/0000-0002-1186-2146
authors.initials: MJ
authors.lastname: Bullock
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis; D003937:Diagnosis, Differential; D006222:Hamartoma / Q000175:diagnosis; D006801:Humans; D010212:Papilloma / Q000175:diagnosis; D010254:Paranasal Sinus Diseases / Q000175:diagnosis*; D010255:Paranasal Sinus Neoplasms / Q000175:diagnosis*
keywords: Adenocarcinoma; Nasal cavity; Respiratory epithelial adenomatoid hamartoma; Schneiderian papilloma; Seromucinous hamartoma; Sinonasal tract
references.citation: Hum Pathol. 1984 Apr;15(4):344-51
references.pmid: 6370825
references.citation: Ann Otol Rhinol Laryngol. 1995 Aug;104(8):639-45
references.pmid: 7639474
references.citation: Am J Surg Pathol. 2009 Mar;33(3):401-8
references.pmid: 19011560
references.citation: Am J Rhinol Allergy. 2013 Jul-Aug;27(4):322-8
references.pmid: 23883815
references.citation: Head Neck Pathol. 2014 Mar;8(1):1-15
references.pmid: 24595418
references.citation: Clin Exp Otorhinolaryngol. 2013 Jun;6(2):107-9
references.pmid: 23799170
references.citation: Am J Surg Pathol. 2015 May;39(5):714-21
references.pmid: 25634744
references.citation: J Laryngol Otol. 2010 Jul;124(7):705-15
references.pmid: 20388243
references.citation: Hum Pathol. 2013 Sep;44(9):1937-40
references.pmid: 23465282
references.citation: Mod Pathol. 2002 Mar;15(3):279-97
references.pmid: 11904343
references.citation: Am J Rhinol Allergy. 2013 Jul-Aug;27(4):287-92
references.pmid: 23883810
references.citation: Oral Surg Oral Med Oral Pathol. 1974 Nov;38(5):760-2
references.pmid: 4530965
references.citation: Head Neck Pathol. 2010 Mar;4(1):77-83
references.pmid: 20237993
references.citation: Head Neck Pathol. 2012 Sep;6(3):395-9
references.pmid: 22392408
references.citation: Rhinology. 1997 Jun;35(2):74-8
references.pmid: 9299655
references.citation: Otolaryngol Head Neck Surg. 2006 Jan;134(1):168-9
references.pmid: 16399201
references.citation: Cancer. 1982 Jul 15;50(2):312-22
references.pmid: 7083137
references.citation: Arch Pathol Lab Med. 2001 Oct;125(10):1365-7
references.pmid: 11570918
references.citation: Am J Surg Pathol. 2013 Nov;37(11):1678-85
references.pmid: 24121171
references.citation: Cancer. 1989 May 1;63(9):1708-13
references.pmid: 2539243
references.citation: Head Neck Pathol. 2007 Sep;1(1):38-43
references.pmid: 20614280
references.citation: Virchows Arch. 2010 Dec;457(6):727-34
references.pmid: 20922408
references.citation: Am J Surg Pathol. 2006 Dec;30(12):1576-80
references.pmid: 17122514
references.citation: Laryngoscope. 1995 Mar;105(3 Pt 1):282-8
references.pmid: 7877417
references.citation: Am J Surg Pathol. 1990 Apr;14(4):364-9
references.pmid: 2321700
references.citation: Head Neck Pathol. 2011 Sep;5(3):241-7
references.pmid: 21618016
references.citation: J Clin Pathol. 2009 Dec;62(12):1085-95
references.pmid: 19946095
references.citation: Histopathology. 2000 Apr;36(4):376-7
references.pmid: 10841649
references.citation: Arch Pathol Lab Med. 2007 Apr;131(4):530-7
references.pmid: 17425380
references.citation: Head Neck Pathol. 2008 Sep;2(3):203-8
references.pmid: 20614315
references.citation: J Clin Pathol. 2003 Mar;56(3):174-81
references.pmid: 12610092
references.citation: Histopathology. 2009 Jan;54(2):205-13
references.pmid: 19207945