title: Sinonasal tract eosinophilic angiocentric fibrosis. A report of three cases.
abstract: Eosinophilic angiocentric fibrosis (EAF) is a rare submucosal fibrosis without 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, respectively. The patients experienced a nasal cavity mass, maxillary pain, or nasal obstructive symptoms of long duration. The process involved the nasal septum (n = 2), nasal cavity (n = 1), and/or the maxillary sinus (n = 1). There was no evidence for Wegener granulomatosis, Churg-Strauss syndrome, Kimura disease, granuloma faciale, or erythema elevatum diutinum. Histologically, the lesions demonstrated a characteristic perivascular "onion-skin" fibrosis and a full spectrum of inflammatory cells, although eosinophils predominated. Necrosis and foreign body-type giant cells were not identified. Surgical excision was used for all patients, who are all alive but with disease at last follow-up. Sinonasal tract EAF is a unique fibroproliferative disorder that does not seem to have systemic associations with known diseases. The characteristic histomorphologic features permit accurate diagnosis.
authors.affiliation: Department of Endocrine and Otorhinolaryngic-Head & Neck Pathology, Armed Forces Institute of Pathology, 6825 16th St, NW, Washington, DC 20306-6000, USA.
authors.forename: L D
authors.initials: LD
authors.lastname: Thompson
authors.forename: D K
authors.initials: DK
authors.lastname: Heffner
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D004802:Eosinophilia / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D005260:Female; D005355:Fibrosis / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000209:etiology / Q000473:pathology; D009668:Nose Diseases / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D010256:Paranasal Sinuses / Q000378:metabolism / Q000473:pathology* / Q000601:surgery
chemical_list: D015415:Biomarkers