Differentials

Nasopharyngeal polyposis

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Facial congestion/pressure/fullness occurs in 70% to 85% of patients.

Discoloured nasal discharge (anterior/posterior or both): occurs in 51% to 83% of patients.

Hyposmia (reduced sense of smell): occurs in 61% to 69% of patients.

Do not metastasise.

INVESTIGATIONS

Fluid-filled lesions on imaging.

Histologically benign.[Figure caption and citation for the preceding image starts]: Grade 3 nasal polypsFrom the collection of Dr Richard Hewitt [Citation ends].com.bmj.content.model.Caption@6f59aa40

Nasopharyngeal angiofibroma

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Do not metastasise, though locally aggressive. Almost exclusively presents in adolescent males.

INVESTIGATIONS

Highly vascular lesions on imaging.

Histologically benign.

Lymphoma

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Palatal perforation is a classic presentation of NK/T-cell lymphomas.[28]​​ B symptoms (fever, night sweats, and unintentional weight loss) are more common with lymphomas than with nasopharyngeal cancer (NPC).

INVESTIGATIONS

Biopsy and flow cytometry show non-epithelial origin, in contrast to NPC, and classify type of lymphoma.

NK/T-cell lymphomas show angioinvasion and necrosis and stain for CD2, CD56.

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