Angiomatous Nasal Polyps in a 43-Year-Old Female From North-Central Nigeria: A Case Report

Abstract

Angiomatous nasal polyps (ANPs) are uncommon variants of nasal polyps, which, like their more common counterparts, are a significant and common cause of morbidity for patients, regardless of demographic variations. As a group, nasal polyps are non-neoplastic and commonly arise within the maxillary antrum, sphenoid, and ethmoid sinuses, protruding via the ostia into the nasal cavity. Their precise cause is unknown, but several factors related to genetics, local infections, family history, and environment have been implicated in their etiopathogenesis. ANPs are commonly diagnosed in the younger age group and are particularly significant because they may mimic benign and malignant vascular tumors occurring within the nasopharynx. We report a rare case of angiomatous nasal polyp in a 43-year-old Nigerian female. ANPs should be included in the differential diagnosis of mass lesions of the nasal cavity in adult patients (male or female) who present with obstructive symptoms and should be distinguished from both benign and malignant neoplastic mimics.

Keywords: angiomatous nasal polyp; chronic rhinosinusitis; nasal congestion; nasal polyps; rhinorrhea.

Figure 1. Plain axial CT images of the maxillary sinuses.

(A) Isodense mass in the right maxillary sinus (yellow arrow) and increased mucosal thickness in the left maxillary sinus (green arrow). (B) Increased mucosal thickness of the left ethmoidal sinuses (green arrow).

Figure 2. Photomicrographs of angiomatous nasal polyp.

(A) Low-power view showing overlying epithelium (yellow arrow), proliferations of variably sized, congested blood vessels (green arrows), and islands of mucous glands (red arrows), all of which are set in fibromyxoid stroma. (B) Medium-power view of the image in (A), with the overlying epithelium (yellow arrow) confirmed to be pseudostratified, ciliated columnar epithelium. Mucous glands (red arrows) are seen in the stroma beneath the epithelium; the endothelium lining the congested blood vessels (green arrows) and the mucinous epithelium lining the mucous glands (red arrows) are also clearly demonstrated. (C) Trabeculae of mature bone at the periphery of the lesion (yellow arrow). The variably sized, congested blood vessels (green arrows) are also shown, set in fibromyxoid stroma. (D) High-power image showing that some of the blood vessels (green arrows) are thick-walled, and there are periglandular infiltrates of chronic inflammatory cells around the mucous glands (red arrows).