Extensively myxoid and hyalinized sinonasal capillary hemangioma: a clinicopathological study of three cases / 中华病理学杂志

ABSTRACT

Objective@#To investigate the clinicopathological features of extensively myxoid and hyalinized sinonasal capillary hemangioma (EMH-SNCH).@*Methods@#Three cases of EMH-SNCH were collected from the First Affiliated Hospital of Zhejiang University School of Medicine and Zhejiang Provincial People′s Hospital from January 2014 to December 2017. The clinical features, histomorphologic changes and immunohistochemical findings were analyzed and the relevant literature was reviewed.@*Results@#All three patients were elderly men aged 65, 51 and 80 years, respectively. Clinically, all cases presented with nasal congestion with repeated epistasis. The maximum diameters of the tumors were 2.0, 3.5 and 1.8 cm respectively. Microscopically, the lesions consisted of randomly distributed, diffusely proliferating capillary-like blood vessels within a loose interstitium with extensive myxoid and hyalinized degeneration. Myxoid and hyalinized regions occupied the vast majority of tumors, ranging from 80% to 95%. Scattered staghorn-shaped branching blood vessels were seen in the tumor, some of which were distended by thrombi. In the deep part of the lesion, capillary clusters rich in endothelial cells with focal lobular arrangement were observed. Immunohistochemically, the vascular endothelial cells expressed CD31, CD34 and ERG diffusely and β-catenin at the membrane, and the pericytes surrounding the capillaries expressed SMA. All three patients were followed up for 16 to 46 months, and no tumor recurrence was observed.@*Conclusions@#EMH-SNCH is a rare subtype of capillary hemangioma of the sinonasal cavity. It is biologically benign and its histological differential diagnosis spectrum is broad. Careful morphologic observation combined with immunohistochemical staining can help its diagnosis and differential diagnosis.