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Eosinophilic Angiocentric Fibrosis of the Nasal Septum

DOI: 10.1155/2013/267285

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Background. Eosinophilic angiocentric fibrosis (EAF) is a rare benign condition of unknown aetiology that causes stenosis of the upper respiratory tract. It is most commonly found at the nasal septum and sinus mucosa causing mucosal thickening and nasal obstructive symptoms. The diagnosis is mainly based on characteristic histologic findings. Case Report. A 27-year-old young woman presented with a slow growing mass at her anterior nasal septum for over eight years. She complained of persistent nasal obstruction, epistaxis, sometimes diffused facial pain, and chronic headache. 3 years ago, the tumor was partially resected for ventilation and a nasal septum perforation was left. Imaging findings indicated soft-tissue thickening of the anterior part of septum and adjacent lateral nasal walls. Pathological examination showed numerous inflammatory cells infiltrates containing eosinophils, fibroinflammatory lesion with a whorled appearance fibrosis which typically surrounded vessels. A diagnosis of eosinophilic angiocentric fibrosis was made. All laboratory tests were unremarkable. Skin prick test was positive. The tumor-like lesion was totally resected. Conclusions. EAF is a rare benign and progressive disorder causing destruction. Combined with radiological imaging of EAF historical findings contribute to the diagnosis. It is important to prevent tumor from recurrence by total resection of the lesion. 1. Introduction Eosinophilic angiocentric fibrosis (EAF) is a rare, benign condition of unknown aetiology which may cause local tissue progressive destruction [1]. It mainly involves the sinonasal tract and is especially common at the nasal septum. EAF typically presents in young to middle-aged females. Most of the patients complain of progressive sinonasal obstructive with a tumor-like lesion. The etiology of EAF is unknown, and the diagnosis is mainly based on histologic findings. The histologic features include perivascular inflammatory cell infiltration (mainly eosinophils). The eosinophils infiltration is gradually replaced by the progressive fibrosis lesion with “onion-skin” pattern around small blood vessels [1–6]. It was first described by Holmes and Panje in 1983 who reported a case of so-called ‘‘intranasal granuloma faciale” [7]. After two years, Roberts and McCann reported two female patients with an unusual stenosing lesion involving the upper respiratory. They gave a descriptive diagnosis according to the histologic findings: eosinophilic angiocentric fibrosis [8]. Until now, 51 patients diagnosed with EAF have been reported in the English

References

[1]  D. B. Nguyen, J. C. Alex, and B. Calhoun, “Eosinophilic angiocentric fibrosis in a patient with nasal obstruction,” Ear, Nose and Throat Journal, vol. 83, no. 3, pp. 183–186, 2004.
[2]  S. ?nder and A. Sungur, “Eosinophilic angiocentric fibrosis: an unusual entity of the sinonasal tract,” Archives of Pathology and Laboratory Medicine, vol. 128, no. 1, pp. 90–91, 2004.
[3]  N. Watanabe and K. Moriwaki, “Atypical eosinophilic angiocentric fibrosis on nasal septum,” Auris Nasus Larynx, vol. 33, no. 3, pp. 355–358, 2006.
[4]  J. Sunde, K. A. Alexander, V. V. B. Reddy, and B. A. Woodworth, “Intranasal eosinophilic angiocentric fibrosis: a case report and review,” Head and Neck Pathology, vol. 4, no. 3, pp. 246–248, 2010.
[5]  L. Clauser, S. Mandrioli, J. Polito, and E. Marchetti, “Eosinophilic angiocentric fibrosis,” Journal of Craniofacial Surgery, vol. 17, no. 4, pp. 812–814, 2006.
[6]  R. Jain, J. V. Robblee, E. O'Sullivan-Mejia et al., “Sinonasal eosinophilic angiocentric fibrosis: a report of four cases and review of literature,” Head and Neck Pathology, vol. 2, no. 4, pp. 309–315, 2008.
[7]  D. K. Holmes and W. R. Panje, “Intranasal granuloma faciale,” American Journal of Otolaryngology, vol. 4, no. 3, pp. 184–186, 1983.
[8]  P. F. Roberts and B. G. McCann, “Eosinophilic angiocentric fibrosis of the upper respiratory tract: a mucosal variant of granuloma faciale? A report of three cases,” Histopathology, vol. 9, no. 11, pp. 1217–1225, 1985.
[9]  V. Deshpande, A. Khosroshahi, G. P. Nielsen, D. L. Hamilos, and J. H. Stone, “Eosinophilic angiocentric fibrosis is a form of IgG4-related systemic disease,” American Journal of Surgical Pathology, vol. 35, no. 5, pp. 701–706, 2011.
[10]  B. T. Yang, Y. Z. Wang, X. Y. Wang, and Z. C. Wang, “Nasal cavity eosinophilic angiocentric fibrosis: CT and MR imaging findings,” American Journal of Neuroradiology, vol. 32, no. 11, pp. 2149–2153, 2011.
[11]  I. Syed, A. Smithard, H. Sharif, and N. Bleach, “Pathology quiz case 2. Eosinophilic angiocentric fibrosis (EAF),” Archives of Otolaryngology- Head and Neck Surgery, vol. 135, no. 7, pp. 721–723, 2009.
[12]  J. M. Holsinger, C. Magro, C. Allen, D. Powell, and A. Agrawal, “Eosinophilic angiocentric fibrosis,” Journal of Otolaryngology- Head and Neck Surgery, vol. 37, no. 5, pp. E155–E158, 2008.
[13]  H. Kiratli, S. ?nder, S. Yildiz, and H. ?z?eker, “Eosinophilic angiocentric fibrosis of the orbit,” Clinical and Experimental Ophthalmology, vol. 36, no. 3, pp. 274–276, 2008.
[14]  O. Kosarac, M. A. Luna, J. Y. Ro, and A. G. Ayala, “Eosinophilic angiocentric fibrosis of the sinonasal tract,” Annals of Diagnostic Pathology, vol. 12, no. 4, pp. 267–270, 2008.
[15]  E. Nigar, R. Dhillon, E. Carr, and R. N. Matin, “Eosinophilic angiocentric fibrosis and extrafacial granuloma faciale,” Histopathology, vol. 51, no. 5, pp. 729–731, 2007.
[16]  Y. Slovik, M. Putterman, M. Nash, and N. Sion-Vardy, “Eosinophilic angiocentric fibrosis of the sinonasal tract in a male patient with chronic bowel inflammation,” American Journal of Rhinology, vol. 20, no. 1, pp. 91–94, 2006.
[17]  A. A. Valenzuela, K. Whitehead, I. Brown, and T. J. Sullivan, “Eosinophilic angiogentric fibrosis: an unusual entity producing complete lacrimal duct obstruction,” Orbit, vol. 25, no. 2, pp. 159–161, 2006.
[18]  I. Leibovitch, C. L. James, P. J. Wormald, and D. Selva, “Orbital eosinophilic angiocentric fibrosis: case report and review of the literature,” Ophthalmology, vol. 113, no. 1, pp. 148–152, 2006.
[19]  S. A. Holme, P. Laidler, and P. J. A. Holt, “Concurrent granuloma faciale and eosinophilic angiocentric fibrosis,” British Journal of Dermatology, vol. 153, no. 4, pp. 851–853, 2005.
[20]  J. Narayan and A. G. Douglas-Jones, “Eosinophilic angiocentric fibrosis and granuloma faciale: analysis of cellular infiltrate and review of literature,” Annals of Otology, Rhinology and Laryngology, vol. 114, no. 1, pp. 35–42, 2005.
[21]  A. Yung, R. Wachsmuth, R. Ramnath, W. Merchant, A. E. Myatt, and R. Sheehan-Dare, “Eosinophilic angiocentric fibrosis—a rare mucosal variant of granuloma faciale which may present to the dermatologist,” British Journal of Dermatology, vol. 152, no. 3, pp. 574–576, 2005.
[22]  S. Paun, V. J. Lund, and A. Gallimore, “Nasal fibrosis: long-term follow up of four cases of eosinophilic angiocentric fibrosis,” Journal of Laryngology and Otology, vol. 119, no. 2, pp. 119–124, 2005.
[23]  P. A. V. Chinelli, M. Y. Kawashita, M. N. Sotto, and M. M. S. Nico, “Granuloma faciale associated with sinonasal tract eosinophilic angiocentric fibrosis,” Acta Dermato-Venereologica, vol. 84, no. 6, pp. 486–487, 2004.
[24]  N. C. Goldman, “Angiocentric eosinophilic fibrosis,” Otolaryngology- Head and Neck Surgery, vol. 128, no. 3, pp. 445–446, 2003.
[25]  A. Tabaee, M. H. Zadeh, M. Proytcheva, and A. LaBruna, “Eosinophilic angiocentric fibrosis,” Journal of Laryngology and Otology, vol. 117, no. 5, pp. 410–413, 2003.
[26]  A. O. Owa, S. Boyle, and A. P. Gallimore, “Eosinophilic angiocentric fibrosis as a cause of nasal obstruction,” Rhinology, vol. 40, no. 1, pp. 41–43, 2002.
[27]  E. M. Pereira, I. Millas, J. S. Reis-Filho, S. A. Maeda, and M. Franco, “Eosinophilic angiocentric fibrosis of the sinonasal tract: report on the clinicopathologic features of a case and review of the literature,” Head and Neck, vol. 24, no. 3, pp. 307–311, 2002.
[28]  B. V. Burns, P. F. Roberts, J. De Carpentier, and A. P. Zarod, “Eosinophilic angiocentric fibrosis affecting the nasal cavity. A mucosal variant of the skin lesion granuloma faciale,” Journal of Laryngology and Otology, vol. 115, no. 3, pp. 223–226, 2001.
[29]  J. Loane, M. Jaramillo, H. A. Young, and K. M. Kerr, “Eosinophilic angiocentric fibrosis and Wegener's granulomatosis: a case report and literature review,” Journal of Clinical Pathology, vol. 54, no. 8, pp. 640–641, 2001.
[30]  L. D. R. Thompson and D. K. Heffner, “Sinonasal tract eosinophilic angiocentric fibrosis: a report of three cases,” American Journal of Clinical Pathology, vol. 115, no. 2, pp. 243–248, 2001.
[31]  V. Matai, S. Baer, S. Barnes, and M. Boxer, “Eosinophilic angiocentric fibrosis,” Journal of Laryngology and Otology, vol. 114, no. 7, pp. 563–564, 2000.
[32]  A. M. Altemani, B. Z. Pilch, E. Sakano, and J. M. Altemani, “Eosinophilic angiocentric fibrosis of the nasal cavity,” Modern Pathology, vol. 10, no. 4, pp. 391–393, 1997.
[33]  P. F. Roberts and B. G. McCann, “Eosinophilic angiocentric fibrosis of the upper respiratory tract: a postscript,” Histopathology, vol. 31, no. 4, pp. 385–386, 1997.
[34]  N. A. Fageeh, K. T. Mai, and P. F. Odell, “Eosinophilic angiocentric fibrosis of the subglottic region of the larynx and upper trachea,” Journal of Otolaryngology, vol. 25, no. 4, pp. 276–278, 1996.
[35]  P. B. Wood, S. R. Parikh, and J. R. Krause, “Extranodal NK/T-cell lymphoma, nasal type,” Proceedings (Baylor University. Medical Center), vol. 24, no. 3, pp. 251–254, 2011.
[36]  A. Bacciu, S. Bacciu, G. Mercante et al., “Ear, nose and throat manifestations of Churg-Strauss syndrome,” Acta Oto-Laryngologica, vol. 126, no. 5, pp. 503–509, 2006.
[37]  M. E. Borke, M. U. Nwagu, D. Obaseki, and N. O. Bazuaye, “Churg Strauss syndrome: a review,” Nigerian Medical Journal, vol. 19, no. 2, pp. 136–139, 2010.
[38]  M. A. Al-Muharraqi, M. K. Faqi, F. Uddin, K. Ladak, and A. Darwish, “Angiolymphoid hyperplasia with eosinophilia (epithelioid hemangioma) of the face: an unusual presentation,” International Journal of Surgery Case Reports, vol. 2, no. 8, pp. 258–260, 2011.

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