患者,男,45岁。15年前曾因左鼻塞及反复鼻衄在外院行鼻腔肿物摘除术,病理诊断为“海绵状平滑肌纤维瘤”。术后偶有双鼻交替性鼻塞,近一个多月来进行性持续性左鼻塞并反复较大量鼻出血,伴流粘液血涕、无耳鸣、头痛等症状。检查:双鼻粘膜充血、双鼻甲肿大,左下甲上部可见一暗红色肿物,表面光滑,附少许粘液血性分泌物,质地实,易出血。住院后行肿物摘除术。病理检查:进检物无包膜,但表面较光滑,暗红色;切面实质灰白色。镜检:肿瘤表面被覆假复层柱状上皮,部分坏死。瘤细胞大,呈多边形,卵圆形、梭形等、胞界不清,胞浆丰富,淡伊红染,细颗粒状,核大小不一致,部份核大深染,染色质粗,核仁 Patient, male, 45 years old. Fifteen years ago, he had had nasal cavity mass removed in the external hospital due to left nasal congestion and repeated nasal discharge. The pathological diagnosis was “spongy smooth muscle fibroma.” Occasionally there were occasional double-nasal alternating nasal obstructions, continuous persistent left nasal obstruction and repeated large amount of epistaxis, accompanied by mucoid blood stasis, no tinnitus, headache and other symptoms. Examination: double nasal mucosa congestion, double turbinate enlargement, a dark red mass on the upper left lower part of the nail, the surface is smooth, with a little mucus bloody discharge, texture, and easy bleeding. The tumor was removed after hospitalization. Pathological examination: The specimens were not coated, but the surface was smooth and dark red; the cut surface was grayish in nature. Microscopic examination: The tumor surface was covered with a pseudostratified columnar epithelium with partial necrosis. The tumor cells are large, polygonal, ovoid, spindle, etc., unclear in the cytoplasm, abundant in cytoplasm, pale erythema, fine granules, inconsistent nucleus size, large nuclear dark staining, coarse chromatin, nucleoli