Sinonasal tract eosinophilic angiocentric fibrosis - A report of three cases

Eosinophilic angiocentric fibrosis (EAF) is a rare submucosal fibrosis with out a well-developed differential diagnosis. Three cases of sinonasal tract EAF were identified in 2 women and 1 man, aged 49, 64, and 28 years, respe ctively. The patients experienced a nasal cavity mass, maxillary pain, or n asal obstructive symptoms of long duration. The process involved the nasal septum (n = 2), nasal cavity (n = 1), and/or the maxillary sinus (n = 1). T here was no evidence for Wegener granulomatosis, Churg-Strauss syndrome Kim ura disease, granuloma faciale, or erythema elevatum diutinum. Histological ly, the lesions demonstrated a characteristic perivascular "onion-skin" fib rosis and a full spectrum of inflammatory cells, although eosinophils predo minated. Necrosis and foreign body-type giant cells were not identified Sur gical excision was used for all patients, who are all alive but with diseas e at last follow-up. Sinonasal tract EAF is a unique fibroproliferative dis order that does not seem to have systemic associations with known diseases. The characteristic histomorphologic features permit accurate diagnosis.