鼻咽纤维血管瘤的影像表现及临床

features of NAs, including strong contrast enhancement on CT and
MR images, signal-void areas representing tumor vessels visible on MR images, as well as intensive vascular blush demonstrated
3.鼻咽非霍奇金淋巴瘤：以青壮年多见，病变侵犯范围 较广，增强扫描呈轻度强化，骨质破坏少见，转移常见，如转移 到皮肤、胃肠道、肝、淋巴结等。
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on angiography .
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Selective angiography is a useful diagnostic method to demonstrate tumor vascular composition and confirms the
intensive contrast enhancement on CT and magnetic
resonance imaging (MRI) scans, and abundant vascularity on angiography.
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Background
cavity, paranasal sinuses, sphenoid-palatine foramen and
infratemporal fossa. In 10–20 % of the casesBiblioteka Baidutumor invades the cranial cavity 。
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Fig. 2 Magnetic resonance, saggital T1-weighted image after contrast administration.
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Enhancement on CT and MRI as well as signal-void areas on MR images, typical for high flow vessels (Fig. 2). Arteriography revealed abundant vascularity with main blood supply from the internal maxillary artery.
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影像图像
图7 MRI T1WI增强
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图8 MRI T1WI增强
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图9 MRI T1WI增强
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影像图像
图10 DSA冠状位
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图11 DSA矢状位
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患者：男，26岁 主诉：右鼻出血2天 现病史：患者输2天前无明显诱因出现右鼻出血，为鲜血，呈滴状，先从左前鼻 孔出，后亦从口中、右鼻流出，数分钟后停止，反复出现多次，总量约为100ml， 无鼻塞，流涕，嗅觉正常。无头痛、发热、咳嗽、打鼾，无耳鸣、而鼻塞感， 无听力下降。于当地医院治疗，予以鼻腔填塞，症状好转。在中山陈星海医院， 予以电子喉镜检查“右鼻腔肿物，性质待查”。 既往史：否认肝炎、结核、疟疾病史，否认高血压、心脏病史，否认糖尿病、 脑血管疾病史，否认手术、外伤、输血史，否认食物、药物等过敏史，否认吸 烟、饮酒史，否认毒物接触史。
diagnosis. It also allows tumor embolization, which reduces
intraoperative hemorrhage, symptoms and bleeding. in a Due to of a risk of profound clinical presence characteristic
Histologic section of the tumor (H&E stain) shows fibrous stroma with ectatic, thin-walled vascular channels
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Enhancement on CT and MRI as well as signal-void areas on MR images, typical for high flow vessels (Fig. 2).
underwent CT, (MRI) and carotid
contrast。
arteriography with
preoperative embolization. The lesion showed intensive
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Fig. 1 Computed tomography, coronal plane, shows homogenous tumor mass in the right nasal cavity

Nasal
tumor
underwent
CT,
which
demonstrated
homogenous mass, with contrast enhancement ranging from strong to intermediate (Fig. 1).In one case, signs of bony destruction with tumor invasion to the ethmoid sinus were visible. The patient with the tumor of the infratemporal fossa
wide, irregular vessels with a single layer of endothelial cells, embedded in fibrous stroma. The abundant vascular component is responsible for excessive bleeding during surgery or following biopsies. It also contributes to certain characteristic radiological
classic radiological findings, preoperative
biopsy is not recommended in the management of NAs.
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鉴别诊断要点
1.鼻咽纤维血管瘤：常见于男性青少年，有多次鼻出血病 史，影像检查见鼻咽部软组织肿块，多伴有压迫性骨质吸收破坏 ；增强扫描病灶明显强化。 2.鼻咽癌：最常发生于中年人，回缩性血涕是其典型早期临 床表现之一，影像检查见鼻咽部浸润性肿块，边界不清，侵蚀性 骨质破坏明显，增强扫描呈轻中度强化，颈部淋巴结肿大往往为 初诊的首发症状。
鼻咽纤维血管瘤的影像表现及临床
读书报告会

患者：男，26岁 主诉：右鼻出血2天
图1 CT平扫
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图2 CT增强
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影像图像
图3 增强矢状位
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图4 骨窗
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影像图像
图5 MRI T1WI
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图6 MRI T2WI
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Abstract

Nasopharyngeal angiofibroma (NA) is a rare,vascular tumor affecting dolescent males. Due to aggressive local growth, skull base location and risk of profound hemorrhage, NA is a challenge for surgeons.Angiofibromas tumor showed
Arteriography revealed abundant vascularity with main blood
supply from the internal maxillary artery.
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Discussion

Histopathological appearance typical for NA consists of numerous

(NA) is a rare vascular tumor, which represents 0.05 % of all head and neck tumors. At the same time, it is the most common benign neoplasm of the nasopharynx . NA occurs predominantly in adolescent males. Although histologically
benign it shows locally aggressive growth with bone
destruction and spread through natural foramina and fissures.
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It originates from the posterolateral wall of the nasopharynx and from this site usually extends to the nasopharynx, nasal