Clin Exp Otorhinolaryngol.  2014 Dec;7(4):334-337. 10.3342/ceo.2014.7.4.334.

Vegetable or Pulse Granuloma in the Nasal Cavity

Affiliations
  • 1Department of Otolaryngology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea. newnew1@hanmail.net
  • 2Department of Pathology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.

Abstract

Vegetable granuloma or pulse granuloma results from the implantation of food particles of vegetable origin. Pulse granulomas have mainly been reported in association with lung aspirations, the oral cavity with a history of oral procedures and less frequently in gastrointestinal tracks. We report a 31-year-old woman who presented with right nasal obstruction and was found to have a firm mass in the right nasal cavity. Paranasal sinus computerized tomography scans identified a calcified ring lesion in her right nasal cavity. Endoscopic sinus surgery was performed, and pathology examination revealed a lesion consistent with a pulse granuloma that contains starch granules with cellulose envelopes appearing as hyaline rings surrounded by inflammation cells and concentrically arranged delicate connective tissue. Pulse granuloma is a well described entity with distinct histopathology. However, pulse granulomas are rare, and especially extraoral pulse granulomas are extremely rare. We found that pulse granuloma can be occurred in the nasal cavity through regurgitation.

Keyword

Granuloma; Nasal cavity; Nose; Paranasal sinuses neoplasms

MeSH Terms

Adult
Aspirations (Psychology)
Cellulose
Connective Tissue
Female
Granuloma*
Humans
Hyalin
Inflammation
Lung
Mouth
Nasal Cavity*
Nasal Obstruction
Nose
Pathology
Starch
Vegetables*
Cellulose
Starch

Figure

  • Fig. 1 A firm mass (arrow) adhering to the right inferior turbinate, middle turbinate and the nasal septum in right nasal cavity with purulent discharge on nasal endoscopic finding.

  • Fig. 2 The axial (A) and coronal (B) paranasal sinus computed tomography scans showing calcified ring lesion (arrow) in the right nasal cavity and bilateral maxillary sinusitis.

  • Fig. 3 The microscopic findings. (A, B) A degenerated wall of plant (vegetable matter) is surrounded by calcified amorphous material (H&E, ×40 and ×400, respectively). (C-E) The wall of plant is positive for both periodic acid Schiff and alcian blue pH 2.5 stains, but negative for Van Gieson stain (×200, respectively).


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