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Respiratory Epithelial Adenomatoid Hamartoma: Diagnostic Pitfalls With Emphasis on Differential Diagnosis

Sangoi, Ankur R. MD; Berry, Gerald MD

Advances in Anatomic Pathology: January 2007 - Volume 14 - Issue 1 - pp 11-16
doi: 10.1097/PAP.0b013e31802efb1e
Review Articles

In the upper aerodigestive tract, respiratory epithelial adenomatoid hamartoma (REAH) is described as a polypoid proliferation of glands lined by ciliated respiratory epithelium that seem to invaginate downward into the submucosa while maintaining direct continuity with the surface mucosa. The lesion can be confused with a variety of benign and malignant entities, including inflammatory polyp, inverted schneiderian papilloma, and low-grade sinonasal adenocarcinoma. In reviewing the historical, clinical, gross, and histopathologic features of REAH and its subtypes, we elucidate how the distinction of REAH with florid mucinous metaplasia from low-grade adenocarcinoma can be challenging particularly in the setting of small biopsy samples. Diagnostic criteria are reviewed with emphasis on key distinguishing characteristics. The significance of this distinction is paramount in preventing unwarranted surgery and untoward consequences for the patient.

Department of Pathology, Stanford University, 300 Pasteur Drive, Room L235, Stanford, CA 94305

No financial support obtained.

Reprints: Ankur R. Sangoi, MD, Department of Pathology, Stanford University, 300 Pasteur Drive, Room L235, Stanford, CA 94305 (e-mail: asangoi@stanford.edu).

No statistical reviewers required.

No conflict of interests.

© 2007 Lippincott Williams & Wilkins, Inc.