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https://doi.org/10.14300/mnnc.2022.17012

Angiogenesis as a typical pathologic process in recurrent epistaxis

[Otorhinolaryngology]
Natalia Boiko; Irina Veniaminovna Stagnieva; Valentinovna Bykova Victoria;

A histological and ultrastructural study of mucoperichondrium biopsy specimens was carry out in 17 patients aged between 32 and 56, suffering from idiopathic recurrent epistaxis. Histological study of mucoperichondrium biopsy specimens showed thickened epithelium foci of up to 257±19.6 mmc at a ratio of the basal, intermediate and upper layers of 1:12.3:4.4. The epithelium revealed a presence of the human papillomavirus infection marker cells – koilocytes. Evident thickening of the epithelium layer is associated with vascular invasion in this cell mass, thus providing trophism. Newly-formed vessels invade in the thickened epithelial layer as part of connective mammuli, they are tortuous, thin-walled, partly devoid of the basic membrane, with a variable luminal diameter. These vascular endothelium is at many places cast-off, dystrophic, which leads to thrombosis and necrosis of adjacent tissues with formation of microerosions or deeper mucosa alterations and hemorrhage development. The ultrastructural study showed the endothelial cell cytoplasm contained a lot of Weibel – Palade bodies, which indicates activation of angiogenesis. Our investigation shows that persistent human papillomavirus infection might result in epistaxis due to angiogenesis induced in the nasal mucosa.

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Keywords: epistaxis, morphological changes, nasal mucosa, angiogenesis