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Free Content Hemorrhagic and Hypervascular Sinonasal Masses: A Review

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Sinonasal masses are uncommon and can be challenging to evaluate. Hemorrhage and hypervascularity in association with sinonasal masses may allow radiologists to narrow the differential diagnosis and begin planning further work-up and treatment. Localizing abnormal blood vessels in hypervascular masses may also help to avoid complications related to biopsy and/or surgery. The purpose of this article is to review the imaging and histopathologic features of hemorrhagic and hypervascular sinonasal masses, including sinonasal organized hematoma, lobular capillary hemangioma, cholesterol granuloma, reparative giant cell granuloma, juvenile nasopharyngeal angiofibroma, rhabdomyosarcoma, hemangiopericytoma, hemangioma, sinonasal mucosal melanoma, and metastases. In this article, we present CT and MR imaging algorithms for arriving at a diagnosis and provide a differential diagnosis for sinonasal lesions that mimick hemorrhagic and/or hypervascular masses.

Learning Objective: Review the clinical and demographic features of hemorrhagic and hypervascular sinonasal masses, along with their imaging features.
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Keywords: JNA = juvenile nasopharyngeal angiofibroma; LCH = lobular capillary hemangioma; SOH = sinonasal organized hematoma; VVM = venous vascular malformation

Document Type: Research Article

Publication date: April 1, 2019

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  • Neurographics is the peer-reviewed, bimonthly educational journal of the American Society of Neuroradiology. The journal comprises articles selected from material presented at the ASNR Annual Meeting. Neurographics also publishes other high-quality submissions that are primarily educational and have a high emphasis on a pictorial approach. Neurographics offers CME credit for reading review articles and completing quiz-based self-assessment activities. CME credit for review articles may be claimed up to 3 years after an article's publication date. Visit to view all available CME courses.
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