Hemorrhagic and Hypervascular Sinonasal Masses: A Review

C.C.V. Lima, D.M. Yousem, S. James Zinreich, M. Nersesyan, D. Reh, and N. Aygun

View Article on Neurographics Website

Date of Activity Release: April 4, 2019
Date of Activity Expiration: April 4, 2022

Target Audience:
Intended for neuroradiologists and neuroradiology trainees with varying degrees of experience.

Learning Objective:
Review the clinical and demographic features of hemorrhagic and hypervascular sinonasal masses, along with their imaging features.

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.

Commercial Support
No commercial support was received for this activity.

Credit Designation Statement

The American Society of Neuroradiology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Society of Neuroradiology designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Method of Physician Participation:
Each participant will review the corresponding Neurographics article located at Upon completion, each physician will complete and pass a post-test with a score of at least 80% to receive a CME certificate.

All individuals in control of content have disclosed the following relevant financial relationships. All of these relationships were treated as a conflict of interest, and have been resolved (C7 SCS 6.1-6.2, 6.5)

D.M. Yousem - UNRELATED: Expert testimony: Medicolegal; Payment for lectures, including service on speakers bureaus: ACR Ed Center; Royalties: Elsevier, Comments: five books; Travel/accommodations/meeting expenses unrelated to activities listed: RSNA 2018 meeting as awardee.

N. Aygun - UNRELATED: Royalties: Elsevier.

D. Reh - UNRELATED: Consultancy: Optinose; Payment for lectures, including service on speakers bureaus: Optinose.





Barton Branstetter 

Editor in Chief

None, N/A

Adam Flanders

Deputy Editor

Royalties, Lippincott Williams and Wilkins

Robert Quencer 

Consulting Editor

None, N/A

Mark Mullins

Associate Editor

Non-remunerative position, AUR6

Meng Law

Associate Editor

Stockholder, Clinical Imaging

Edward Escott

Associate Editor

Grant, Atherysys, Inc.; Royalties, Thieme Medical Publishers

Scott Faro

Associate Editor

None, N/A

Tina Young Poussaint

Associate Editor

None, N/A

Dheeraj Ghandi

Associate Editor

Grant, Arstasis, Axera Inc.; Consultant, Covidien, EV3

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