Olfactory neuroblastoma (esthesioneuroblastoma) arises from which cell type, and what is the Kadish staging system criterion for Stage C disease?

• A Olfactory sensory neurons (bipolar sensory cells) of the olfactory neuroepithelium; Stage C = extension beyond the nasal cavity and paranasal sinuses (orbit, skull base, intracranium, cervical nodes, distant) ✓
• B Columnar respiratory epithelium; Stage C = extension to paranasal sinuses and nasopharynx
• C Neuroendocrine cells of the sinus mucosa; Stage C = involvement of bilateral nasal cavities
• D Basal reserve cells of the olfactory epithelium; Stage C = metastasis to cervical lymph nodes only

Explanation

Olfactory neuroblastoma (esthesioneuroblastoma) arises from the specialised olfactory sensory neurons (or their progenitor basal cells) of the olfactory neuroepithelium in the superior nasal vault, cribriform plate, and upper nasal septum. Kadish staging: Stage A — confined to nasal cavity; Stage B — involves paranasal sinuses; Stage C — extends beyond nasal cavity and sinuses to include orbit, skull base, intracranial extension, cervical nodes, or distant metastases. Stage C has a significantly worse prognosis and typically requires combined surgery plus radiotherapy with or without chemotherapy.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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