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Sinonasal Tract Eosinophilic Angiocentric Fibrosis
A Report of Three Cases

Lester D.R. Thompson MD, Dennis K. Heffner MD
DOI: http://dx.doi.org/10.1309/7D97-83KY-6NW2-5608 243-248 First published online: 1 February 2001

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 “onionskin” 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.

Key Words:
  • Sinuses
  • Nasal cavity
  • Eosinophilic angiocentric fibrosis
  • Histology
  • Immunohistochemistry
  • Prognosis
  • Adult