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血管扩张性息肉——一名年轻成年人中不寻常的鼻腔肿物

Angiectatic Polyp-An Unusual Nasal Mass in a Young Adult.

作者信息

Kshithi K, V Apoorva K, Saha Nikita Narayan, Shenoy Vijendra, K Rahul, Dhawan Saksham, Aggarwal Ishaan

机构信息

Dept of ENT and Head & neck surgery, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4744-4748. doi: 10.1007/s12070-024-04823-4. Epub 2024 Jun 25.

Abstract

Angiectatic nasal polyps (ANP) are rare pseudo-neoplastic lesions that might raise intriguing pathophysiological issues and present a significant diagnostic challenge. They are also referred to as inflammatory granuloma telangiectaticum, vascular granuloma, pseudo-angioma, and angiomatous/angiectatic polyp. However, the name angiectatic polyp refers to the fact that the lesion is not a true tumour and is clinically distinguished by ectatic vasculature, haemorrhage, and persistent proliferation. The most confusing aspect of this polyp is its clinical appearance, which resembles a juvenile nasal angiofibroma. Despite its typical imaging characteristics, this lesion is difficult to differentiate radiologically. Hence, histopathology is paramount for establishing diagnosis. We report a rare case of a young adult who presented with complaints of nasal block and epistaxis. Examination revealed a vascular nasal mass and CT scan demonstrated the lesion to be epicentred in right nasal cavity extending to multiple sinuses with adjacent bone erosion. Patient underwent endoscopic excision of the mass with JNA as the predominant differential and only following histopathological examination, the final diagnosis was confirmed.

摘要

血管扩张性鼻息肉(ANP)是罕见的假性肿瘤性病变,可能引发有趣的病理生理问题,并带来重大的诊断挑战。它们也被称为炎症性毛细血管扩张性肉芽肿、血管性肉芽肿、假性血管瘤以及血管瘤样/血管扩张性息肉。然而,血管扩张性息肉这个名称指的是该病变并非真正的肿瘤,在临床上以扩张的血管、出血和持续增生为特征。这种息肉最令人困惑的方面是其临床表现,类似于青少年鼻血管纤维瘤。尽管其具有典型的影像学特征,但该病变在放射学上很难鉴别。因此,组织病理学对于确诊至关重要。我们报告一例罕见的年轻成人病例,患者主诉鼻塞和鼻出血。检查发现鼻腔有一个血管性肿物,CT扫描显示病变以右侧鼻腔为中心,延伸至多个鼻窦,并伴有相邻骨质侵蚀。患者接受了肿物的内镜切除,最初主要鉴别诊断为青少年鼻血管纤维瘤,仅在组织病理学检查后才确诊。

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本文引用的文献

1
Angiomatous Nasal Polyp: The Great Emulator-A Case Report.血管瘤样鼻息肉:强大的模仿者——病例报告
Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):4730-4733. doi: 10.1007/s12070-021-03040-7. Epub 2022 Jan 24.
2
Angiectatic Sinonasal Polyp: A Diagnostic Challenge.血管扩张性鼻息肉:一项诊断挑战。
Indian J Otolaryngol Head Neck Surg. 2021 Jun;73(2):260-262. doi: 10.1007/s12070-020-02125-z. Epub 2020 Sep 10.
5
Sinonasal organized hematoma: CT and MR imaging findings.鼻窦组织性血肿:CT与MR成像表现
AJNR Am J Neuroradiol. 2008 Jun;29(6):1204-8. doi: 10.3174/ajnr.A1042. Epub 2008 Apr 10.
6
Hemangioma of the nasal cavity: a clinicopathologic study.鼻腔血管瘤:一项临床病理研究
Auris Nasus Larynx. 2002 Oct;29(4):335-9. doi: 10.1016/s0385-8146(02)00028-7.

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