Nasal glial heterotopia.Nasal glial glial /gli·al/ (gli´'l) of or pertaining to the neuroglia. glial of or pertaining to glia or neuroglia. glial limitans a dense network of glial processes at the pia mater. heterotopia (nasal giloma) is the term used to describe a mass made up of mature brain tissue that is isolated from the cranial cavity or spinal canal. Most of these rare, benign, congenital rumors are found in the nasal region, particularly at the bridge of the nose and in the nasal cavity. Nasal glial beterotopia is frequently diagnosed in newborns; a few cases have been found in adults. The differentiation of nasal glial heterotopia from encephalocele is based on the presence of a connection between the mass and the intracranial tissue. However, even with high-resolution computed tomography high-resolution computed tomography Imaging CT at slice–collimation scan interval widths of ≤ 4 mm, which is narrower than the usual 1-3 cm interval 'slices' obtained in conventional CT imaging. Cf Spiral computed tomography. and magnetic resonance imaging magnetic resonance imaging (MRI), noninvasive diagnostic technique that uses nuclear magnetic resonance to produce cross-sectional images of organs and other internal body structures. , the connection may be very small and unapparent. Occasionally, the distinction can be made by noting the presence of meningitis and/or cerebrospinal fluid rhinorrhea cerebrospinal fluid rhinorrhea n. A discharge of cerebrospinal fluid from the nose. , either before or after surgical manipulation. Because of the difficulty in definitively identifying a connection to the brain, caution must be exercised to decrease complications. Histologically, nasal glial heterotopia and encephaloceles are characterized by varying proportions of neurons and gila; they may also contain gemistocyfic astrocytes astrocytes (as´trōsī´ts), n a large, star-shaped cell found in certain tissues of the nervous system. A mass of astrocytes is called astroglia. See also astrocytoma. (figure 1). There are varying degrees of fibrosis, frequently associated with inflammation. Masson's strichrome staining or an S-100 protein and glial fibrillary acidic protein Glial fibrillary acidic protein (GFAP) is an intermediate filament (IF) protein that is found in glial cells such as astrocytes. First described in 1971[1], GFAP is a type III IF protein that maps, in humans, to 17q21. (GFAP) are most helpful in accentuating the neural tissue in the background fibrosis (figure 2). It must be noted that there are no significant histologic differences between lesions with and without a demonstrable central nervous system connection. Therefore, the accurate diagnosis of heterotopia as opposed to encephalocele requires knowledge of the patient's radiographic and/or operative findings. [FIGURE 1-2 OMITTED] Suggested reading Mills SE, Gaffey MJ, Frierson HF. Neural, neuroendocrine, and neuroectodermal neoplasia. Tumors of the upper aerodigestive tract and ear. Third series. Washington, D.C.: Armed Forces Institute of Pathology Armed Forces Institute of Pathology A section of the US military which provides consultations, reference atlases and educational programs for pathologists , 1997:119-200. Penner CR, Thompson LD. Nasal glial heterotopia: A clinicopathologic and immunophenotypic analysis of 10 cases with a review of the literature. Ann Diagn Pathol 2003;7:354-9. From the Department of Pathology, Woodland Hills Medical Center, Southern California Permanente Medical Group, Woodland Hills, Calif (Dr. Thompson). |
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