Differentials
Nasopharyngeal polyposis
SIGNS / SYMPTOMS
Facial congestion/pressure/fullness occurs in 70% to 85% of patients.
Discolored 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 metastasize.
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].
Nasopharyngeal angiofibroma
SIGNS / SYMPTOMS
Do not metastasize, though locally aggressive. Almost exclusively presents in adolescent males.
INVESTIGATIONS
Highly vascular lesions on imaging.
Histologically benign.
Lymphoma
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 nonepithelial 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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