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Year : 2014  |  Volume : 57  |  Issue : 2  |  Page : 338-339
Myospherulosis in the nose: A report of an unusual lesion


1 Department of Pathology, Dr. RPGMC, Tanda, Kangra, Himachal Pradesh, India
2 Department of ENT, Dr. RPGMC, Tanda, Kangra, Himachal Pradesh, India

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Date of Web Publication19-Jun-2014
 

How to cite this article:
Kaul R, Chander B, Dogra SS. Myospherulosis in the nose: A report of an unusual lesion. Indian J Pathol Microbiol 2014;57:338-9

How to cite this URL:
Kaul R, Chander B, Dogra SS. Myospherulosis in the nose: A report of an unusual lesion. Indian J Pathol Microbiol [serial online] 2014 [cited 2020 Oct 28];57:338-9. Available from: https://www.ijpmonline.org/text.asp?2014/57/2/338/134738


A 35-year-old female presented to the out-patient department with the complaint of nasal obstruction. On examination, there was presence of pinkish color mass arising from the inferior natus on the left side [Figure 1]. She gave a history of surgery at the same site for a similar lesion, about 4 months back, when a diagnosis of rhinosporidiosis was made. She was admitted and the mass was removed with lateral rhinotomy approach. The specimen was sent for histopathology. The tissue examined showed dense foreign body giant cell reaction and lymphoplasmacytic infiltrate along with numerous myospherules (parent bodies), varying in diameter from 5 to 8 um containing endobodies [Figure 2]. A diagnosis of myospherulosis, nasal mass was made.
Figure 1: Gross examination showing a pinkish color mass arising from the inferior natus

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Figure 2: Photomicrograph showing "parent bodies" enclosing the endobodies (H and E, ×400)

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   Discussion Top


Myospherulosis or lipogranuloma formation is frequently iatrogenic and is caused by a petrolatum, lanolin, or paraffin-based ointment becoming trapped within tissue. Almost all the cases of myospherulosis are seen in association with antibiotics or hemostatic agents with a base of petrolatum or petroleum. [1] The spherules can be confused with fungi, algae of genus Prototheca, vegetable matter, and pollen grains. The spherules are most easily confused with coccidioidomycosis and rhinosporidiosis, and can be differentiated from the latter by careful light microscopy, by the lack of staining with periodic acid-Schiff and Gomori methenamine silver stains and also by positive immunostaining for hemoglobin. [2]

To elucidate the nature of myospherulosis, Kakizaki and Shimada produced this state in vitro by mixing vitamin E, oleic acid, linoleic acid, and lanolin with human blood components, such as whole blood, washed erythrocytes, plasma, and fixed erythrocytes, respectively. Myospherulosis resulted with all mixtures in these experiments. The authors concluded that the bodies are formed by physical emulsion phenomenon between lipid-containing materials and blood and that subsequently erythrocytes are enclosed in the parent body. [3] Myospherulosis may also be seen without association with exogenous lipids. Chau et al. in their study have reported this entity in 10 out of 27 consecutive renal cell carcinomas, arising from histiocytes and even tumor cells. Myospherules in these cases were smaller and more uniform in size. However no other similar observation in renal cell carcinomas has been reported so far in the literature. [4] Similarly myospherulosis resulting from endogenous local excess of lipid material like in steatocystoma, mature cystic teratoma, cases of breast surgery and perirenal adipose tissue have been reported. [5],[6]

 
   References Top

1.Culviner WT, Leonard DW, Wilhelmsen CL, Bolger WE. Experimental myospherulosis of the paranasal sinuses: A histologic rabbit study. Am J Rhinol 2000;14:131-7.  Back to cited text no. 1
    
2.Kini U, Babu MK. Ocular spherulocystosis. J Clin Pathol 1996;49:857-8.  Back to cited text no. 2
    
3.Kakizaki H, Shimada K. Experimental study of the cause of myospherulosis. Am J Clin Pathol 1993;99:249-56.  Back to cited text no. 3
    
4.Chau KY, Pretorius JM, Stewart AW. Myospherulosis in renal cell carcinoma. Arch Pathol Lab Med 2000;124:1476-9.  Back to cited text no. 4
    
5.Vuong PN. Spontaneous myospherulosis developing at contact with a mature cystic dysembryoma of the ovary. Pathogenetic discussion apropos of a case diagnosed by laparoscopic biopsy. J Gynecol Obstet Biol Reprod (Paris) 1988;17:15-8.  Back to cited text no. 5
[PUBMED]    
6.Hata S, Kanomata N, Kozuka Y, Fukuya M, Kobayashi TK, Ohno E, et al. Cytologic appearance of myospherulosis of the breast diagnosed by fine-needle aspirates: A clinical, cytological and immunocytochemical study of 23 cases. Diagn Cytopathol 2011;39:177-80.  Back to cited text no. 6
    

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Correspondence Address:
Rashmi Kaul
C-15, Type V Flats, Dr. RPGMC Campus, Tanda, Kangra - 176 001, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0377-4929.134738

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