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International Journal of Otolaryngology
Volume 2013, Article ID 539642, 6 pages
http://dx.doi.org/10.1155/2013/539642
Clinical Study

Clinical and Pathological Characteristics of Organized Hematoma

1Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan
2Department of Otorhinolaryngology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan
3Division of Medical Biochemistry, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga 840-8502, Japan

Received 13 December 2012; Accepted 13 February 2013

Academic Editor: David W. Eisele

Copyright © 2013 Nobuo Ohta et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To study the clinical and pathological characteristics of patients with organized hematoma with malignant features in maxillary sinuses. Subjects and Methods. This was a retrospective study of five patients who were treated surgically for organized hematoma. The preoperative CT and MRI findings were studied clinically. The expressions of CD31, CD34, and periostin in surgical samples were investigated by immunohistochemistry. Results. The clinical features of organized hematoma, such as a mass expanding from the maxillary sinus with bone destruction, resembled those of maxillary carcinoma. However, CT and MRI provided sufficient and useful information to differentiate this condition from malignancy. Surgical resection was the first-line treatment because of the presence of a firm capsule. Characteristic histopathological findings were a mixture of dilated vessels, hemorrhage, fibrin exudation, fibrosis, hyalinization, and neovascularization. The expressions of periostin, CD31, and CD34 were observed in organized hematoma of the maxillary sinus. Conclusion. The expressions of periostin, CD31, and CD34 were observed in organized hematoma of the maxillary sinus. Organized hematoma is characterized pathologically by a mixture of bleeding, dilated vessels, hemorrhage, fibrin exudation, fibrosis, hyalinization, and neovascularization. CT and MRI show heterogeneous findings reflecting a mixture of these pathological entities.