Inverted Papilloma

ICD-O:8121/1

Inverted papillomas (or Schneiderian papillomas) arising outside the sinonasal tract are extremely rare. One publication reported 15 pharyngeal inverted papillomas, 11 of which arose in the nasopharynx [183]. The pink or grey firm polyps had a convoluted surface, which cor-

Fig. 6.4. Respiratory epithelial adenomatoid hamartoma. a This fragmented surgical specimen of polypoid hamartoma displays numerous fluid and mucin filled cysts. b The surface is lined by tall columnar respiratory epithelium and there are widely spaced acinar proliferations embedded in a fibrous stroma. c The acinar proliferations are in continuity with invaginations of the surface respiratory epithelium and recapitulate either seromucous glands. The basement membrane is typically thickened

Fig. 6.4. Respiratory epithelial adenomatoid hamartoma. a This fragmented surgical specimen of polypoid hamartoma displays numerous fluid and mucin filled cysts. b The surface is lined by tall columnar respiratory epithelium and there are widely spaced acinar proliferations embedded in a fibrous stroma. c The acinar proliferations are in continuity with invaginations of the surface respiratory epithelium and recapitulate either seromucous glands. The basement membrane is typically thickened responded histologically to a multilayered, transitional-type epithelium with foci of respiratory and squamous epithelium growing endophytically into the underlying loose and myxoid stroma. Nasopharyngeal inverted papillomas have an increased potential for recurrence, which is higher in the nasopharynx than in the sinonasal location. This probably reflects the high rate of incomplete initial removal due to the unexpected nature of the lesion and the difficult nasopharyngeal anatomy. As in a sinonasal location, inverted papillomas are at risk of malignant transformation. For a detailed description of inverted papillomas, see Chap. 2.

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