Rhinoscleroma

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Rhinoscleroma
Diagnosis in short

Rhinoscleroma. H&E stain.

LM macrophages with clear-to-foamy cytoplasm, lymphocytes, plasma cells
LM DDx Rosai-Dorfman disease
Stains Warthin-Starry stain +ve (rod-shaped organisms)
IHC CD68 +ve, S-100 -ve
Site head and neck - usu. nose

Signs nasal deformation (late)
Prevalence rare

Rhinoscleroma is a rare infectious condition of the head and neck.

General

  • Caused by Klebsiella rhinoscleromatis.
  • Nose involved +95% of the time.[1]

Gross

  • Nasal mass - may be deforming.

Image:

Microscopic

Features:[2]

  • Macrophages - clear-to-foamy cytoplasm.
  • Lymphocytes.
  • Plasma cells.

DDx:

Images

www:

Stains

  • Warthin-Starry stain +ve (rod-shaped organisms).
  • Dieterle stain +ve (rod-shaped organisms).

See also

References

  1. Chan, TV.; Spiegel, JH. (Oct 2007). "Klebsiella rhinoscleromatis of the membranous nasal septum.". J Laryngol Otol 121 (10): 998-1002. doi:10.1017/S0022215107006421. PMID 17359555.
  2. URL: http://www.brown.edu/Courses/Digital_Path/systemic_path/hn/rhinoscleroma2.html. Accessed on: 18 January 2012.
  3. Iyer VK, Handa KK, Sharma MC (July 2009). "Variable extent of emperipolesis in the evolution of Rosai Dorfman disease: Diagnostic and pathogenetic implications". J Cytol 26 (3): 111–6. doi:10.4103/0970-9371.59398. PMC 3168012. PMID 21938169. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168012/.
  4. URL: http://www.jameswpattersonmd.com/case_studies/index.cfm?CFID=387434. Accessed on: 21 February 2012.