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Case No. 390
2015-11-01~2015-11-30
출제자 : 유인선
Hit : 318
| Period | 2015-11-01~2015-11-30 |
|---|---|
| Diagnosis | Sinonasal organized hematoma |
| Clinical information | M/53 C.C> 3년전부터 시작된 nasal obstruction |
| Discussion | Sinonasal organized hematoma • Uncommon nonneoplastic benign condition, may locally aggressive , Caused by trauma, surgery, bleeding diathesis, hemorrhagic lesion in sinuses • M/C in maxillary sinus • Clinical symptoms: frequent epistaxis and nasal obstruction (m/c), rhinorrhea, facial pain. • Treatment: surgical resection (by ESS or C-L op) • CT -Ill defined, large expansile mass with bony erosion (smooth, nonaggressive cortical breakthrough and scalloping of sinus wall), heterogeneous high /iso attenuation compared to inferior turbinate soft tissue (IT) • MR -Well marginated especially on T2 WI -T1: Isointense with hyperintense foci (compared to IT). -T2: Marked heterogeneous signal, mixed hypo/ isointense with hyperintense foci and hypointense peripheral rim (fibrous pseudocapsule) -T1+C: Irregular, nodular, papillary, fondlike enhancement (of isointense area on T2, prominent vascular proliferation area) |
| Correct answer |
Correct Answer
Semi-Correct Answer |