Pseudotumours

Mucocele is a cyst filled with mucus that develops within a sinus cavity as the result of occlusion of the ostium. Most commonly it is due to infection, but may also result from trauma or be congenital [109]. Retained secretions cause expansion of the sinus and bone erosion. The most common sites of occurrence are the frontal and the sphenoidal sinuses. The cyst is lined by respiratory epithelium that shows prominent goblet-cell hyperplasia [158, 184]. Expansion of the cyst may cause atrophy and metaplasia of the epithelium.

Organising haematoma, also known as "cholesterol granuloma" or "rhinitis caseosa", is in most cases the result of occult submucosal haemorrhage in the maxillary sinus due to external trauma or tooth extraction [147]. Resolution of the haematoma produces the formation of cholesterol granulomas and fibrosis, simulating a foreign body reaction.

Isolated amyloid deposition in the sinonasal mucosa is a rare event, with about 20 cases reported in the English-language literature [180, 258]. Grossly, the lesion appears as a friable tumour-like mass, with a tendency to bleed. Histologically, there is a deposition of intensely eosinophilic material in the stroma, around blood vessels and around ducts of the mucoserous glands, which is often associated with diffuse chronic inflammation and foreign body granulomatous reaction. Amyloid stains orange with Congo red, and showed apple green birefringence under polarised light examination. Im-munohistochemistry may help to identify the type of amyloid deposition.

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