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Soft Tissue Pathology 

Pathology of Sinonasal Hemangiopericytoma

Dr Sampurna Roy MD

 

Path Quiz Case 16: Case history and histopathology images

Diagnosis: Sinonasal Hemangiopericytoma

 

                                                                                                                      

 

Sinonasal hemangiopericytoma  is a rare upper aerodigestive tract tumour of unknown histogenesis.

The most frequent site of occurence is the nasal cavity and paranasal sinuses.

Microscopic features:  

Image1 ; Image2 ; Image3 ; Image4 Image 5 ; Image6

The tumour is composed of uniform, spindle shaped cells with round to oval  nuclei arranged in short fascicles. 

The vascular component includes capillary size to large sinusoidal spaces.

Some vessels have a staghorn like appearance. 

Perivascular hyalinization is often present.

Subtypes of Sinonasal Hemangiopericytoma:

 I) Soft tissue type hemangiopericytoma:    

Aggressive tumour; 

Locally destructive and may metastasize to regional lymphnode and lung  ;

Do not show myoid differentiation ; 

Smooth muscle actin and other myoid markers are negative;

Very recently intimate relationships between hemangiopericytoma and solitary fibrous tumor have been reported.

 It is important to differentiate these tumours, because most solitary fibrous tumors of the soft tissue are benign.

 II) True hemangiopericytoma:   

Benign behaviour ;

Do not metastasize ; 

Tumour has a myogenic appearance and shows convincing pericytic differentiation ;

Smooth muscle actin is positive ;

Some of these tumours recur locally. 

 III) Sinonasal glomus tumours:   Striking pathology gold: a singular experience with daily reverberations: sinonasal hemangiopericytoma (glomangiopericytoma) and oncogenic osteomalacia.Head Neck Pathol. 2012 Mar;6(1):64-74

Histology ranges from a typical glomus tumour composed of compact epithelioid cells to tumours indistinguishable from perivascular myoma.

Glomus and glomus-like tumours and true hemangiopericytomas are likely to belong to one cellular spectrum.

Further reading

Glomangiopericytoma (sinonasal-type haemangiopericytoma).

Glomangiopericytoma of the nasal cavity.

Sinonasal glomangiopericytoma.

FDG PET/CT findings of a glomangiopericytoma.

Intranasal glomus tumor.

Aggressive glomus tumor of the nasal region. Report of a case with multiple local recurrences.

Nasal glomus tumors: report of two cases with emphasis on immunohistochemical features and differential diagnosis.
 

 

Differential Diagnosis of Sinonasal Hemangiopericytoma:  Sinonasal true hemangiopericytoma should be differentiated from soft tissue- type hemangiopericytoma because of its far better prognosis.

Solitary fibrous tumour (CD34 is diffusely positive); Cellular Angiofibroma ; Fibrohistiocytic tumourLobular capillary hemangioma ; Glomus tumour  

                                                                                             

Further reading

Sinonasal hemangiopericytoma in the columellar base, an unusual location.

Sinonasal-type hemangiopericytoma of the nasal cavity and paranasal sinus.

An immunohistochemical study of sinonasal hemangiopericytoma.

F-18 FDG PET/CT findings of primary sinonasal hemangiopericytoma: rare location in a young adult patient.

Tumour induced osteomalacia due to a sinonasal hemangiopericytoma: A case report.

Endoscopic Resection of Sinonasal Hemangiopericytoma following Preoperative Embolisation: A Case Report and Literature Review.

Management of sinonasal hemangiopericytomas: a systematic review.

Sinonasal hemangiopericytoma-like tumor with true pericytic myoid differentiation: a clinicopathologic and immunohistochemical study of five cases.

Sinonasal type hemangiopericytoma: a clinicopathologic and immunophenotypic analysis of 104 showing perivascular  myoid differentiation. 

Intranasal pericytic tumors (glomus tumor and sinonasal hemangiopericytoma-like tumor): report of two cases with review of the literature.

Sinonasal hemangiopericytoma like tumour: a sinonasal glomus tumour or a hemangiopericytoma?

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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