Hg. Yfantis et al., Angiectatic nasal polyps that clinically simulate a malignant process - Report of 2 cases and review of the literature, ARCH PATH L, 124(3), 2000, pp. 406-410
Citations number
38
Categorie Soggetti
Research/Laboratory Medicine & Medical Tecnology","Medical Research Diagnosis & Treatment
Background.-Approximately 5% of inflammatory or allergic sinonasal polyps d
evelop extensive vascular proliferation and ectasia with deposition of pseu
doamyloid, These so-called angiectatic nasal polyps (ANPs) can grow rapidly
and exhibit an aggressive clinical behavior that could simulate malignancy
preoperatively.
Objective.-To systematically address the differential histologic diagnosis
of ANPs.
Methods.-We evaluated by light microscopy, immunohistochemistry, and electr
on microscopy biopsy and resection specimens from 2 large ANPs (8 and 10 cm
in diameter) that presented in 2 adult men with life-threatening epistaxis
and facial deformity, respectively.
Results.-The tumors were firm, lobulated, and covered by smooth, partially
ulcerated mucosa. Histologically, clusters of dilated, thin-walled blood ve
ssels embedded in pools of Congo red-negative eosinophilic material, associ
ated with patchy necrosis and atypical stromal spindle cells, were seen. El
ectron microscopy and immunohistochemistry (CD34, factor VIII) confirmed th
e endothelial nature of the cells lining the spaces, whereas the atypical s
tromal cells were classified as myofibroblasts.
Conclusions.-These 2 cases represent extreme examples of ANPs that clinical
ly simulate a malignant process, Awareness of the histological features of
ANPs should prevent confusion of such lesions with other vascular or spindl
e cell lesions of the nasopharynx that would require different treatment an
d carry a different prognosis.