Nasal Hemangiopericytoma –A Pathological Illusion

摘要

Objective: We report a case of rare nasal mass whose histopathological diagnosis was lobular capillary hemangioma but immunohistochemistry reported it to be hemangiopericytoma.Case report: Lobular capillary hemangioma and hemangiopericytoma are very rare vascular tumours arising from the nasal cavity. Here we report a case of rare nasal mass, which presented with nasal obstruction and epistaxis. Frozen section biopsy reported benign vascular tumour. Final biopsy report of excised mass was sent to different pathologists at different places. Both of them confirmed to the diagnosis of lobular capillary hemangioma. Due to atypical clinical picture which was not correlating with the histopathological diagnosis, tissue was sent for immunohistochemistry, which altered the final diagnosis to hemangiopericytoma.Conclusions: Every nasal mass should be looked with suspicion especially in older age group and patient should be kept under close observation. The facility of immunohiostochemistry should be utilized in cases where there is lack of clinicopathological correlation. Introduction Among common benign nasal masses lobular capillary hemangioma and hemangiopericytoma are very rare vascular tumours arising from the nasal cavity. The clinical picture, course and treatment of both these tumours is entirely different. Histopathological picture of both these tumours is sometimes very confusing which creates dilemma for the treating surgeon to suggest the patient about prognosis of the disease and final outcome of the treatment. Here comes the role of immunohistochemistry, which can differentiate between different tumours by using different stains. Case report A 43 year old male patient presented to our OPD with chief complaints of epistaxis, nasal obstruction and headache from last two months. Epistaxis was episodic, relieved spontaneously and never required hospitalization. There was no history of hypertension, trauma or any other major systemic illness. On examination of nose there was no external deformity. On anterior rhinoscopy left side of nasal cavity was filled with a mass (Fig.1) which was dirty white in colour, non tender, friable, firm to soft in consistency and there was no bleeding in probing the mass.