Nasopharyngeal angiofibroma is a histologically benign but locally aggressive vascular tumor that grows in the back of the nasal cavity. It most commonly affects adolescent males and may grow into fissures of the. Nasoangiofibroma youth is a highly vascularized tumor almost exclusively male adolescents presentation. % represents % of head and. Angiofibroma nasofaring juvenile – Free download as PDF File .pdf), Text File . txt) or read online for free.
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Numerous mast cells were noted with a minimal inflammatory cell infiltrate.
Thank you for updating your details. JNA classically presents as a painless, progressive unilateral nasal obstruction. JNA is classified as Type I when the tumor is restricted to the nasal cavity and the nasopharynx without bone destruction, Type II when the tumor invades the pterygomaxillary fossa and maxillary, sphenoidal and ethmoid sinuses with bone destruction, Type III when the tumor invades the infratemporal fossa, the orbit, and the parasellar region but remains lateral to the cavernous sinus and Type IV when the tumor invades the cavernous sinus, the optic chiasma and the pituitary fossa.
A wait and watch policy with periodic imaging may thus postpone or eliminate the need for surgery and reduce morbidity. Sagittal section in computed tomography scans showing site and extent of the lesion. Mortality is not associated with nasopharyngeal angiofibroma.
Genetic evidence for an androgen-dependent tumor? It is an aggressive neoplasm and shows a propensity for destructive local spread often extending angiofibeoma the base of the skull and into the cranium. Fisch classification, however, is currently accepted. Typically a lobulated non-encapsulated soft tissue mass is demonstrated centred on the sphenopalatine foramen which is often widened and usually bowing the posterior wall of the maxillary antrum anteriorly.
Juvenile nasopharyngeal angiofibroma | Radiology Reference Article |
These lesions include inflammatory polyps, angiomatous polyps, nasopharyngeal cysts and carcinomas, soft tissue neoplasms such as papilloma, lymphoma, neurofibroma, maxillary malignancies, nasal fossa esthesioneuroblastoma, adenoid hypertrophy, cervical vertebrae cordomas and retropharyngeal ganglia tuberculosis.
Findings are similar to those described above. Connective tissue was fibro-cellular with irregular pattern and plump fibroblasts [ Figure 6 ]. This makes it possible to precisely stage JNA. Nzsofaring may be an option if surgery is not possible or only incomplete resection achieved 2,4,6. Prognosis for nasopharyngeal angiofibroma is favorable. Support Center Support Center.
The location and size of the tumor and feeding vessels are clearly demonstrated by this technique. Imaging in the diagnosis of juvenile nasopharyngeal angiofibroma. Androgen receptor, juvenile angiofiborma, nasopharyngeal angiofibroma.
Indian J Dent Res. Markers of vascular differentiation, proliferation and tissue remodeling in juvenile nasopharyngeal angiofibromas. Antral sign or Holman-Miller sign forward bowing of posterior wall of maxilla is pathognomic of angiofibroma. Int J Pediatr Otorhinolaryngol. Macroscopically this tumor appears as a rounded, circumscribed, noncapsulated mucosa angioibroma mass.
Pathology Outlines – Nasopharyngeal angiofibroma
Arteriography followed by preoperative embolization and surgical resection is the treatment of choice. Continuous growth involves the sphenoidal sinus, nasal fossa and middle turbinate, pterygomaxillary fossa and the posterior wall of the maxillary sinus as seen in the present case.
Case 6 Case 6. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment.
W B Saunders Co. The excised gross specimen was soft to firm in consistency, white to yellow with darker vascular areas. This may be attributed to a rich vasculature and lack of encapsulation. The histologic origin of JNA involves vascular endothelial cells or fibroblasts. However, most authors agree that JNAs arise from the posterior choanal tissues in the region of the sphenopalatine foramen.
The hormonal influence in JNA remains controversial. The main clinical presentation of JNA is unilateral nasal obstruction with or without epistaxis. Numerous blood vessels with irregular size and shape were seen with a single lining endothelial cell layer. Views Read Edit View history.
Anterior bowing of the posterior maxillary wall, due to invasion of the pterygomaxillary space on axial CT, known as the Holman-Miller sign is one of the characteristic findings. Case 2 Case 2. The final diagnosis is achieved by histopathologic examination of tissue sections either on incisional or excisional biopsy.
Ear Nose Throat J. Case 4 Case 4. It most commonly affects adolescent males and may grow into fissures of the skull and may spread to adjacent structures. It accounts for 0. MRI is superior to CT for detecting soft tissue extension of the tumor intracranially.
Endoscopic approach is an excellent tool in primary and recurrent JNA, it allows visualisation and precise removal of the lesion. Edit article Share article View revision history. Histopathologically JNA shows a fibrocellular stroma with spindle cells and haphazardly arranged collagen interspersed with an irregular vascular pattern.
Angiography is a useful adjunct in the diagnosis of vascular tumors. They develop at a juvenilf older age and occur more commonly in women.