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Nasal Eosinophilic Angiocentric Fibrosis with Orbital Extension

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Eosinophilic angiocentric fibrosis (EAF) is an extremely rare, chronic, benign, idiopathic disorder that mostly affects the upper respiratory tract, particularly the nasal cavity, and features progressive submucosal perivascular fibrosis. To the best of our knowledge, only seven cases of EAF with orbital involvement have been reported. We report a case of sinonasal EAF with orbital extension that presented with left nasolacrimal duct obstruction. A 35-year-old man presented with left epiphora, proptosis, anterolateral globe displacement and nasal obstruction. Endoscopic sinus examination showed a firm, gritty, creamy, yellow, fibrous, adherent mass of maxillary sinus. Diagnosis was established with histopathological examination of excisional biopsy of the lesion. Although EAF is very rare, it should be considered in the differential diagnosis of lesions of upper airway tract, particularly the nasal cavity. Biopsy is necessary for diagnosis and treatment planning. Resecting of the involved tissues completely is essential for prevention of recurrence.

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  1. Sune J, Alexander KA, Reddy VV, Woodworth BA. Intranasal eosinophilic angiocentric fibrosis: a case report and review. Head Neck Pathol. 2010;4(3):246–8. doi:10.1007/s12105-010-0185-3.

    Article  Google Scholar 

  2. Paun S, Lund VJ, Gallimore A. Nasal fibrosis: long-term follow up of four cases of eosinophilic angiocentric fibrosis. J Laryngol Otol. 2005;119(2):119–24.

    Article  PubMed  Google Scholar 

  3. Kosarac O, Luna MA, Ro JY, Ayala AG. Eosinophilic angiocentric fibrosis of the sinonasal tract. Ann Diagn Pathol. 2008;12(4):267–70. doi:10.1016/j.anndiagpath.2007.02.2002.

    Article  PubMed  Google Scholar 

  4. Pereira EM, Millas I, Reis-Filho JS, Maeda SA, Franco M. Eosinophilic angiocentric fibrosis of the sinonasal tract: report on the clinicopathologic features of a case and review of the literature. Head Neck. 2002;24(3):307–11. doi:10.1002/hed.10041.

    Article  PubMed  Google Scholar 

  5. Holmes DK, Panje WR. Intranasal granuloma faciale. Am J Otolaryngol. 1983;4(3):184–6.

    Article  CAS  PubMed  Google Scholar 

  6. Roberts PF, McCann BG. Eosinophilic angiocentric fibrosis of the upper respiratory tract: a mucosal variant of granuloma faciale? A report of three cases. Histopathology. 1985;9(11):1217–25.

    Article  CAS  PubMed  Google Scholar 

  7. Li Y, Liu H, Han D, Zang H, Wang T, Hu B. Eosinophilic angiocentric fibrosis of the nasal septum. Case Rep Otolaryngol. 2013;2013:267285. doi:10.1155/2013/267285.

    PubMed Central  PubMed  Google Scholar 

  8. Karligkiotis A, Volpi L, Ferreli F, Cerati M, Kagkelari E, Meloni F, Castelnuovo P. Primary orbital eosinophilic angiocentric fibrosis with intranasal extension. Head Neck. 2014;36(1):E8–11. doi:10.1002/hed.23396.

    Article  PubMed  Google Scholar 

  9. Kim WJ, Kim YI, Kim JE, Choi YH, Cho HH, Seon HJ, Yoon SH. Unexplained persistent dyspnea in a young woman with eosinophilic angiocentric fibrosis. Respir Care. 2014;59(5):e72–6. doi:10.4187/respcare.02645.

  10. Valenzuela AA, Whitehead KJ, Brown I, Sullivan TJ. Eosinophilic angiocentric fibrosis: an unusual entity producing complete lacrimal duct obstruction. Orbit. 2006;25(2):159–61.

    Article  PubMed  Google Scholar 

  11. Leibovitch I, James CL, Wormald PJ, Selva D. Orbital eosinophilic angiocentric fibrosis case report and review of the literature. Ophthalmology. 2006;113(1):148–52.

    Article  PubMed  Google Scholar 

  12. Azam M, Husen YA, Hasan SH. Eosinophilic angiocentric fibrosis of orbit. Indian J Pathol Microbiol. 2010;53(4):850–2. doi:10.4103/0377-4929.72086.

    Article  PubMed  Google Scholar 

  13. Kirtali H, Onder S, Yildiz S, Ozseker H. Eosinophilic angiocentric fibrosis of the orbit. Clin Exp Ophthalmol. 2008;36(3):274–6. doi:10.1111/j.1442-907.2008.01725.x.

    Article  Google Scholar 

  14. Tabaee A, Zadeh MH, Proytcheva M, LaBruna A. Eosinophilic angiocentric fibrosis. J Laryngol Otol. 2003;117(5):410–3.

    Article  PubMed  Google Scholar 

  15. Yang BT, Wang YZ, Wang ZC. Nasal cavity eosinophilic fibrosis: CT and MR imaging findings. AJNR Am J Neuroradiol. 2011;32(11):2149–53. doi:10.3174/ajnr.A2786.

    Article  CAS  PubMed  Google Scholar 

  16. Slovik Y, Putterman M, Nash M, Sion-Vardy N. Eosinophilic angiocentric fibrosis of the sinonasal tract in a male patient with chronic bowel inflammation. Am J Rhinol. 2006;20(1):91–4.

    PubMed  Google Scholar 

  17. Magro CM, Dyrsen M. Angiocentric lesions of the head and neck. Head Neck Pathol. 2008;2(2):116–30. doi:10.1007/s12105-008-0049-2.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Benlemlih A, Szableski V, Bendahou M, Riviere S, Villain M, Costes V. Eosinophilic angiocentric fibrosis: a form of IgG4-related systemic disease? Ann Pathol. 2012;32(4):271–5. doi:10.1016/j unpaid. 2012.06.008.

    Article  PubMed  Google Scholar 

  19. Deshpande V, Khosroshahi A, Nielsen GP, Hamilos DL, Stone JH. Eosinophilic angiocentric fibrosis is a form of IgG4-related systemic disease. Am J Surg Pathol. 2011;35(5):701–6.

    Article  PubMed  Google Scholar 

  20. Fageeh NA, Mai KT, Odell PF. Eosinophilic angiocentric fibrosis of the larynx and upper trachea. J Otolaryngol. 1996;25(4):276–8.

    CAS  PubMed  Google Scholar 

  21. Thompson LD, Heffner DK. Sinonasal tract eosinophilic angiocentric fibrosis. A report of three cases. Am J Clin Pathol. 2001;115(2):243–8.

    Article  CAS  PubMed  Google Scholar 

  22. Neguyen DB, Alex JC, Calhoun B. Eosinophilic angiocentric fibrosis in a patient with nasal obstruction. Ear Nose Throat J. 2004;83(3):183–6.

    Google Scholar 

  23. Goldman NC. Angiocentric eosinophilic fibrosis. Otolaryngol Head Neck Surg. 2003;128(3):445–6.

    Article  PubMed  Google Scholar 

  24. Narayan J, Douglas-Jones AG. Eosinophilic angiocentric and granuloma faciale: analysis of cellular infiltrate and review of literature. Ann Otol Rhinol Laryngol. 2005;114(1):35–42.

    Article  PubMed  Google Scholar 

  25. Clauser L, Mandrioli S, Polito J, Marchetti E. Eosinophilic angiocentric fibrosis. J Craniofac Surg. 2006;17(4):812–4.

    Article  PubMed  Google Scholar 

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Correspondence to Mohammad Faramarzi.

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Faramarzi, M., Dadgarnia, M.H., Moghimi, M. et al. Nasal Eosinophilic Angiocentric Fibrosis with Orbital Extension. Head and Neck Pathol 9, 426–429 (2015).

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