Head and neck tumours: MRI of inverted papilloma: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Head and neck tumours: MRI of inverted papilloma

Sample item

A 55-year-old man has unilateral nasal obstruction from a mass on the lateral nasal wall extending into the maxillary sinus. Which MRI appearance is characteristic of inverted papilloma?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Convoluted cerebriform pattern of alternating bands

On MRI inverted papilloma shows a convoluted cerebriform pattern of alternating T2 hypointense and enhancing bands, often with the focus of origin on the lateral nasal wall. It is locally aggressive, recurs if incompletely excised and can undergo malignant change, so complete endoscopic resection of the attachment is needed.

Option by option

  • A. Salt and pepper appearance with flow voids

    Salt and pepper appearance is characteristic of a paraganglioma.

  • B. Convoluted cerebriform pattern of alternating bands (correct)

    Correct. The cerebriform striped pattern is characteristic of inverted papilloma.

  • C. Enhancing dural tail with hyperostosis

    A dural tail with hyperostosis is a feature of meningioma.

  • D. Anterior bowing of the posterior maxillary wall

    Anterior bowing of the posterior maxillary wall (Holman-Miller sign) is seen in juvenile angiofibroma.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More ENT questions

Questions about this ENT question

What is the answer to this ENT question?

The best answer is B, Convoluted cerebriform pattern of alternating bands. On MRI inverted papilloma shows a convoluted cerebriform pattern of alternating T2 hypointense and enhancing bands, often with the focus of origin on the lateral nasal wall.

Why is "Salt and pepper appearance with flow voids" not the answer?

Salt and pepper appearance is characteristic of a paraganglioma.

Why is "Enhancing dural tail with hyperostosis" not the answer?

A dural tail with hyperostosis is a feature of meningioma.

Why is "Anterior bowing of the posterior maxillary wall" not the answer?

Anterior bowing of the posterior maxillary wall (Holman-Miller sign) is seen in juvenile angiofibroma.

What concept does this question test?

It tests Head and neck tumours: MRI of inverted papilloma in ENT. It is locally aggressive, recurs if incompletely excised and can undergo malignant change, so complete endoscopic resection of the attachment is needed.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Head and neck tumours: MRI of inverted papilloma?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.