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Case 16175

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Referral category

Disease / syndrome / tumor / condition

Region of interest

1st Quadrant

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Canaray 16175

1. Absent nasal septum suggestive of Wegener's granulomatosis

The nasal septum is absent. The inferior nasal conchae are also absent. This radiographic appearance, coupled with the history of a single episode of a severe nosebleed, is suggestive of Wegener's granulomatosis. A referral to the patient's physician for evaluation to rule out Wegener's granulomatosis is necessary.

2. Granulomatous mass in right maxillary sinus

A well-defined soft tissue mass with thin septae of bone interspersed internally has occupied the entire right maxillary sinus and has expanded and thinned the posterior-lateral wall, the orbital floor, and the lateral nasal wall. This appearance is suggestive of a granuloma, which supports the putative diagnosis of Wegener's granulomatosis. A biopsy of the entity is recommended to confirm the diagnosis.

Axial slices of the right maxilla

These axial slices demonstrate the extension of the sinus opacification throughout the right maxillary sinus and the expansion and loss of the posterior-lateral sinus wall and the right lateral nasal wall.

Sagittal view of right maxillary sinus

These sagittal views demonstrate the wispy bone interspersed throughout the internal structure of the sinus opacification.

Coronal slices of right maxillary sinus

These coronal slices demonstrate the effect of the mass on the lateral borders of the maxilla and on the orbital floor.

3. Retained roots in 2nd, 3rd and 4th quadrants

Roots are retained at sites 26, 28, 38, 46, and 47.

4. Generalized moderate periodontal bone loss

A broad zone of calculus has formed on the lingual surfaces of the mandibular anterior teeth. Generalized moderate horizontal periodontal bone loss is present.