case_images: PMC4073472_01
case_images: Extraoral photograph showing diffuse swelling on left middle third of face extending antero-posteriorly from 1 cm lateral to left ala of the nose till anterior to the tragus of the left ear and supero-inferiorly from left infra-orbital margin to the left corner of mouth
case_images: AMS-4-90-g001.jpg
case_images: PMC4073472_01_AMS-4-90-g001.jpg
case_images: F1
case_images: The swelling was initially small in size and has increased to the present size over a period of 1 month [Figure 1]. It measured 3 cm x 3 cm in size and extends antero-posteriorly from 1 cm lateral to left ala of the nose until anterior to the tragus of the left ear and supero-inferiorly from left infra-orbital margin to the left corner of mouth [Figure 1].
case_images: Intraoral photograph showing single ill-defined, diffuse swelling on left buccal side of maxilla slight obliteration of vestibule along with expansion of buccal and palatal cortical bone
case_images: AMS-4-90-g002.jpg
case_images: PMC4073472_01_AMS-4-90-g002.jpg
case_images: F2
case_images: Overlying mucosa was normal with no ulceration [Figure 2].
case_images: Orthopantomograph showing haziness in left maxillary sinus and is more radiopaque as compared to contralateral sinus
case_images: AMS-4-90-g003.jpg
case_images: PMC4073472_01_AMS-4-90-g003.jpg
case_images: F3
case_images: Orthopantomograph (OPG) revealed a marked area of haziness in left maxillary sinus and is more radio-opaque than contralateral sinus [Figure 3].
case_images: X-ray Water's view, demonstrating haziness in left maxillary sinus with more radiopacity than contralateral sinus
case_images: AMS-4-90-g004.jpg
case_images: PMC4073472_01_AMS-4-90-g004.jpg
case_images: F4
case_images: X-ray water's view, reconfirmed the findings as observed in OPG [Figure 4].
case_images: Computed tomography scan revealing the extent of lesion which extends superiorly to infra-orbital margin medially nasal cavity and inferiorly to maxillary alveolar ridge and laterally expansion of zygoma
case_images: AMS-4-90-g005.jpg
case_images: PMC4073472_01_AMS-4-90-g005.jpg
case_images: F5
case_images: It extends superiorly to infra-orbital margin medially to nasal cavity and inferiorly to maxillary alveolar ridge and laterally expansion of zygoma [Figure 5].
case_images: Diffuse monotonous infiltrate of medium sized or large cells, with interspersed eosinophillic cells (H and E, x40)
case_images: AMS-4-90-g006.jpg
case_images: PMC4073472_01_AMS-4-90-g006.jpg
case_images: F6
case_images: Most of the atypical myeloid cells showed increased nucleo-cytoplasmic ratio with round to ovoid, vesicular, reniform, or multilobated nuclei and finely granular eosinophillic cytoplasm [Figures 6 and 7].
case_images: Myeloid atypical cells showing eosinophillic cytoplasm with fine granularity (H and E, x40)
case_images: AMS-4-90-g007.jpg
case_images: PMC4073472_01_AMS-4-90-g007.jpg
case_images: F7
case_images: Most of the atypical myeloid cells showed increased nucleo-cytoplasmic ratio with round to ovoid, vesicular, reniform, or multilobated nuclei and finely granular eosinophillic cytoplasm [Figures 6 and 7].
case_images: Immunohistochemical stained hotomicrograph showing CD99 positive cells (x40)
case_images: AMS-4-90-g008.jpg
case_images: PMC4073472_01_AMS-4-90-g008.jpg
case_images: F8
case_images: Positive reactivity was observed with CD99 [Figure 8], vimentin [Figure 9], CD31 [Figure 10], myeloperoxidase (MPO) [Figure 11], whereas Desmin, Actin, epithelial membrane antigen [Figure 12], synaptophysin [Figure 13], leukocyte-common antigen (LCA) and CD20 [Figure 14] showed a negative staining.
case_images: Photomicrograph showing Vimentin positive cells (x40)
case_images: AMS-4-90-g009.jpg
case_images: PMC4073472_01_AMS-4-90-g009.jpg
case_images: F9
case_images: Positive reactivity was observed with CD99 [Figure 8], vimentin [Figure 9], CD31 [Figure 10], myeloperoxidase (MPO) [Figure 11], whereas Desmin, Actin, epithelial membrane antigen [Figure 12], synaptophysin [Figure 13], leukocyte-common antigen (LCA) and CD20 [Figure 14] showed a negative staining.
case_images: Immunohistochemical stained photomicrograph showing CD31 positive cells (x40)
case_images: AMS-4-90-g010.jpg
case_images: PMC4073472_01_AMS-4-90-g010.jpg
case_images: F10
case_images: Positive reactivity was observed with CD99 [Figure 8], vimentin [Figure 9], CD31 [Figure 10], myeloperoxidase (MPO) [Figure 11], whereas Desmin, Actin, epithelial membrane antigen [Figure 12], synaptophysin [Figure 13], leukocyte-common antigen (LCA) and CD20 [Figure 14] showed a negative staining.
case_images: Immunohistochemical stained photomicrograph showing myeloperoxidase positive cells (x40)
case_images: AMS-4-90-g011.jpg
case_images: PMC4073472_01_AMS-4-90-g011.jpg
case_images: F11
case_images: Positive reactivity was observed with CD99 [Figure 8], vimentin [Figure 9], CD31 [Figure 10], myeloperoxidase (MPO) [Figure 11], whereas Desmin, Actin, epithelial membrane antigen [Figure 12], synaptophysin [Figure 13], leukocyte-common antigen (LCA) and CD20 [Figure 14] showed a negative staining.
case_images: Immunohistochemical stained photomicrograph showing epithelial membrane antigen negative cells (x40)
case_images: AMS-4-90-g012.jpg
case_images: PMC4073472_01_AMS-4-90-g012.jpg
case_images: F12
case_images: Positive reactivity was observed with CD99 [Figure 8], vimentin [Figure 9], CD31 [Figure 10], myeloperoxidase (MPO) [Figure 11], whereas Desmin, Actin, epithelial membrane antigen [Figure 12], synaptophysin [Figure 13], leukocyte-common antigen (LCA) and CD20 [Figure 14] showed a negative staining.
case_images: Immunohistochemical stained photomicrograph showing negative staining for synaptophysin marker (x40)
case_images: AMS-4-90-g013.jpg
case_images: PMC4073472_01_AMS-4-90-g013.jpg
case_images: F13
case_images: Positive reactivity was observed with CD99 [Figure 8], vimentin [Figure 9], CD31 [Figure 10], myeloperoxidase (MPO) [Figure 11], whereas Desmin, Actin, epithelial membrane antigen [Figure 12], synaptophysin [Figure 13], leukocyte-common antigen (LCA) and CD20 [Figure 14] showed a negative staining.
case_images: Immunohistochemical stained photomicrograph showing negative staining for CD20 marker (x40)
case_images: AMS-4-90-g014.jpg
case_images: PMC4073472_01_AMS-4-90-g014.jpg
case_images: F14
case_images: Positive reactivity was observed with CD99 [Figure 8], vimentin [Figure 9], CD31 [Figure 10], myeloperoxidase (MPO) [Figure 11], whereas Desmin, Actin, epithelial membrane antigen [Figure 12], synaptophysin [Figure 13], leukocyte-common antigen (LCA) and CD20 [Figure 14] showed a negative staining.
case_images: Postoperative photograph showing complete remission of disease
case_images: AMS-4-90-g015.jpg
case_images: PMC4073472_01_AMS-4-90-g015.jpg
case_images: F15
case_images: A complete remission of the disease, with the disappearance of the swelling was observed [Figure 15].