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Imaging studies are performed before surgery or biopsy to preclude an intracranial connection. Images usually show a sharply circumscribed but expansile mass. It may be difficult to exclude the intracranial connection if the defect is small whether employing computed tomography or magnetic resonance.
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may be considered. However, it does not have glial tissue. Further, a polyp usually has mucoserous glands. The lesion is frequently misinterpreted as scar in the subcutaneous tissues, but scar in a < 2-year-old child would be uncommon. Special stains are frequently required to highlight the
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The overlying skin or squamous mucosa is intact and uninvolved by the process. There is normal glial tissue set within a fibrous connective tissue stroma. There is such blending, that the underlying process may be difficult to detect without special studies. In a few cases, large
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nodule at bridge of nose, or as a polypoid mass within the nasal cavity, or somewhere along the upper border of the nasal bow. If the patient presents with an intranasal mass, there may be obstruction, chronic
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Nasal glial heterotopia is rare, while an encephalocele is uncommon. NGH usually presents in infancy, while encephalocele may present in older children and adults. It is seen in both genders equally.
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Penner, C. R.; Thompson, L. (2003). "Nasal glial heterotopia: A clinicopathologic and immunophenotypic analysis of 10 cases with a review of the literature".
216:. However, this term is to be discouraged, as it implies a neoplasm or tumor, which it is not. By definition, nasal glial heterotopia is a specific type of
117:. Sometimes, it is quite firm, especially when there is a large amount of associated fibrosis. The lesions are usually <2 cm in greatest dimension.
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Although surgery is the treatment of choice, it must be preceded by imaging studies to exclude an intracranial connection. Potential complications include
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A split field high power photograph of a trichrome stain (left) and a glial fibrillary acidic protein stain (right) of a nasal glial heterotopia.
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stain will highlight the dual components well, with the glial tissue staining red, while the background fibrosis stains a bright blue.
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There is a subcutaneous nodule identified just below the nasal bridge in this computed tomography image of a nasal glial heterotopia.
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The cut surface shows a smooth, homogeneous glistening to slippery cut surface, showing an appearance similar to
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Patients come to clinical attention early in life (usually at birth or within the first few months), with a firm
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tissue, which are no longer in continuity with an intracranial component. This is distinctly different from an
260:. Recurrences or more correctly persistence may be seen in up to 30% of patients if not completely excised.
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A high power hematoxylin and eosin stained slide showing the delicate neural tissue within dense fibrosis.
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This lesion is separated into two types based on the anatomic site of presentation:
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While nasal glial heterotopia (NGH) is the preferred term, synonyms have included
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133:, neurons, choroid plexus, ependyma, and retinal pigmented cells may be seen.
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The most common missed lesion is within the nasal cavity, where a fibrosed
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426:. Hagerstown, MD: Lippincott Williams & Wilkins. pp. 1:1–2.
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Mixed (10%): Subcutaneous tissues and nasal cavity (larger lesions)
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Diagnostic
Pathology: Head and Neck: Published by Amirsys
91:(CSF) leak, then an encephalocele is much more likely.
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384:Kardon, D. E. (2000). "Nasal glial heterotopia".
240:, it is distinctly different from the trauma or
386:Archives of Pathology & Laboratory Medicine
62:, which is a herniation of brain tissue and/or
422:Lester D. R. Thompson; Bruce M. Wenig (2011).
98:Extranasal (60%): Subcutaneous bridge of nose
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161:The glial tissue is highlighted with
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285:RESERVED, INSERM US14-- ALL RIGHTS.
287:"Orphanet: Nasal glial heterotopia"
236:). As a congenital malformation or
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360:10.1016/j.anndiagpath.2003.09.010
244:development of an encephalocele.
167:glial fibrillary acidic protein
348:Annals of Diagnostic Pathology
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54:of displaced normal, mature
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398:10.5858/2000-124-926b-AORP
258:cerebrospinal fluid leak
48:Nasal glial heterotopia
33:Nasal glial heterotopia
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178:Differential diagnoses
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50:refers to congenital
157:Immunohistochemistry
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294:. Retrieved
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264:Epidemiology
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214:nasal glioma
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163:S100 protein
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131:gemistocytes
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80:subcutaneous
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41:Nasal glioma
450:Soft tissue
187:diagnosis.
184:nasal polyp
38:Other names
272:References
254:meningitis
248:Management
242:iatrogenic
218:choristoma
173:Diagnosis
165:and with
151:trichrome
109:Pathology
444:Category
406:11100076
368:15018118
306:cite web
296:15 March
234:mesoderm
230:endoderm
226:ectoderm
222:teratoma
238:ectopia
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256:and a
115:brain
56:glial
428:ISBN
402:PMID
364:PMID
312:link
298:2019
394:doi
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