DOI: 10.5858/2002-126-0217-cgotms. Cholesterol Granuloma of the Maxillary Sinus

Cholesterol Granuloma of the Maxillary Sinus

10.5858/2002-126-0217-cgotms

Crossref journal-article

Archives of Pathology and Laboratory Medicine

Archives of Pathology & Laboratory Medicine (3906)

Abstract

Abstract Cholesterol granuloma is usually associated with chronic middle ear disease and is common in the mastoid antrum and air cells of the temporal bone. It has also been reported in other parts of the skull, such as the frontal and maxillary sinuses and orbit. Cholesterol granuloma is rare in the paranasal sinuses. We report a new case of cholesterol granuloma in the maxillary sinus of a 38-year-old man who underwent surgical excision. We also review the literature and discuss the mechanism of development for this lesion. The resected specimen showed fragments of respiratory mucosa with cholesterol clefts surrounded by multinucleated foreign-body giant cells. Some multinucleated foreign-body giant cells showed asteroid bodies. Hemorrhagic areas, hemosiderin-laden macrophages, chronic inflammatory cells, and dilated lymphatics vessels were seen as well. Increased intrasinus pressure due to drainage obstruction may affect venous and lymphatic drainage from the sinus cavity, leading to venule microhemorrhages while still allowing arterial blood into the sinus mucosa and further contributing to a large localized hemorrhage. Lymphatic drainage may be insufficient to completely remove the lipid components of the red blood cells, and the lipid accumulation may contribute to the formation of cholesterol crystals and their esters.

Bibliography

Leon, M. E., Chavez, C., Fyfe, B., Nagorsky, M. J., & Garcia, F. U. (2002). Cholesterol Granuloma of the Maxillary Sinus. Archives of Pathology & Laboratory Medicine, 126(2), 217â219.

Authors 5

Marino E. Leon (first)
Carlos Chavez (additional)
Billie Fyfe (additional)
Matthew J. Nagorsky (additional)
Fernando U. Garcia (additional)

References 10 Referenced 38

10.1111/j.1365-2273.1978.tb00678.x / Clin Otolaryngol / Cholesterol granuloma of the maxillary antrum. by Graham (1978)
10.1177/019459989310900530 / Otolaryngol Head Neck Surg / Cholesterol granulomas of the maxillary sinus presenting with nasal obstruction. by Rath-Wolfson (1993)
10.1016/0266-4356(86)90096-3 / Br J Oral Maxillofac Surg / A review of maxillary sinus cholesterol granuloma. by Milton (1986)
10.1017/S0022215100105936 / J Laryngol Otol / Cholesterol granuloma of the maxillary antrum. by Gunes (1988)
10.1016/S0165-5876(86)80031-3 / Int J Pediatr Otorhinolaryngol / Cholesterol crystals in the temporal bone and paranasal sinuses. by Niho (1986)
10.1017/S002221510013991X / J Laryngol Otol / Cholesterol granuloma of the maxillary sinus: six cases from the same region. by Kunt (1998)
10.1227/00006123-198507000-00011 / Neurosurgery / Cholesterol granuloma of the petrous apex and sphenoidal sinus: a case report. by Gray (1985)
{'key': '2021012907551643100_i1543-2165-126-2-217-b8', 'first-page': '125', 'article-title': 'Cholesterol granuloma of the middle ear: report of 5 cases.', 'volume': '50', 'author': 'Campos', 'year': '1996', 'journal-title': 'Acta Otorhinolaryngol Belg'} / Acta Otorhinolaryngol Belg / Cholesterol granuloma of the middle ear: report of 5 cases. by Campos (1996)
10.1288/00005537-199505000-00022 / Laryngoscope / Endoscopic treatment of maxillary sinus cholesterol granuloma. by Marks (1995)
10.1001/archotol.1970.00770040514010 / Arch Otolaryngol / Experimental cholesterol granuloma. by Main (1970)

Dates

Type	When
Created	4 years, 7 months ago (Jan. 29, 2021, 2:55 a.m.)
Deposited	4 years, 7 months ago (Jan. 29, 2021, 2:55 a.m.)
Indexed	4 weeks, 2 days ago (Aug. 6, 2025, 9:57 a.m.)
Issued	23 years, 7 months ago (Feb. 1, 2002)
Published	23 years, 7 months ago (Feb. 1, 2002)
Published Print	23 years, 7 months ago (Feb. 1, 2002)

Funders 0

None

BibTeX

@article{Leon_2002, title={Cholesterol Granuloma of the Maxillary Sinus}, volume={126}, ISSN={0003-9985}, url={http://dx.doi.org/10.5858/2002-126-0217-cgotms}, DOI={10.5858/2002-126-0217-cgotms}, number={2}, journal={Archives of Pathology & Laboratory Medicine}, publisher={Archives of Pathology and Laboratory Medicine}, author={Leon, Marino E. and Chavez, Carlos and Fyfe, Billie and Nagorsky, Matthew J. and Garcia, Fernando U.}, year={2002}, month=feb, pages={217–219} }

JSON

{
  "indexed": {
    "date-parts": [
      [
        2025,
        8,
        6
      ]
    ],
    "date-time": "2025-08-06T13:57:23Z",
    "timestamp": 1754488643561
  },
  "reference-count": 10,
  "publisher": "Archives of Pathology and Laboratory Medicine",
  "issue": "2",
  "content-domain": {
    "domain": [],
    "crossmark-restriction": false
  },
  "published-print": {
    "date-parts": [
      [
        2002,
        2,
        1
      ]
    ]
  },
  "abstract": "<jats:title>Abstract</jats:title>\n               <jats:p>Cholesterol granuloma is usually associated with chronic middle ear disease and is common in the mastoid antrum and air cells of the temporal bone. It has also been reported in other parts of the skull, such as the frontal and maxillary sinuses and orbit. Cholesterol granuloma is rare in the paranasal sinuses. We report a new case of cholesterol granuloma in the maxillary sinus of a 38-year-old man who underwent surgical excision. We also review the literature and discuss the mechanism of development for this lesion. The resected specimen showed fragments of respiratory mucosa with cholesterol clefts surrounded by multinucleated foreign-body giant cells. Some multinucleated foreign-body giant cells showed asteroid bodies. Hemorrhagic areas, hemosiderin-laden macrophages, chronic inflammatory cells, and dilated lymphatics vessels were seen as well. Increased intrasinus pressure due to drainage obstruction may affect venous and lymphatic drainage from the sinus cavity, leading to venule microhemorrhages while still allowing arterial blood into the sinus mucosa and further contributing to a large localized hemorrhage. Lymphatic drainage may be insufficient to completely remove the lipid components of the red blood cells, and the lipid accumulation may contribute to the formation of cholesterol crystals and their esters.</jats:p>",
  "DOI": "10.5858/2002-126-0217-cgotms",
  "type": "journal-article",
  "created": {
    "date-parts": [
      [
        2021,
        1,
        29
      ]
    ],
    "date-time": "2021-01-29T07:55:52Z",
    "timestamp": 1611906952000
  },
  "page": "217-219",
  "source": "Crossref",
  "is-referenced-by-count": 38,
  "title": "Cholesterol Granuloma of the Maxillary Sinus",
  "prefix": "10.5858",
  "volume": "126",
  "author": [
    {
      "given": "Marino E.",
      "family": "Leon",
      "sequence": "first",
      "affiliation": [
        {
          "name": "From the Department of Pathology and Laboratory Medicine, Allegheny General Hospital, Pittsburgh, Pa (Dr Leon); and the Departments of Pathology and Laboratory Medicine (Drs Leon, Chavez, Fyfe, and Garcia) and Otorhinolaryngology\u2013Head and Neck Surgery (Dr Nagorsky), MCP-Hahnemann University, Philadelphia, Pa"
        }
      ]
    },
    {
      "given": "Carlos",
      "family": "Chavez",
      "sequence": "additional",
      "affiliation": [
        {
          "name": "From the Department of Pathology and Laboratory Medicine, Allegheny General Hospital, Pittsburgh, Pa (Dr Leon); and the Departments of Pathology and Laboratory Medicine (Drs Leon, Chavez, Fyfe, and Garcia) and Otorhinolaryngology\u2013Head and Neck Surgery (Dr Nagorsky), MCP-Hahnemann University, Philadelphia, Pa"
        }
      ]
    },
    {
      "given": "Billie",
      "family": "Fyfe",
      "sequence": "additional",
      "affiliation": [
        {
          "name": "From the Department of Pathology and Laboratory Medicine, Allegheny General Hospital, Pittsburgh, Pa (Dr Leon); and the Departments of Pathology and Laboratory Medicine (Drs Leon, Chavez, Fyfe, and Garcia) and Otorhinolaryngology\u2013Head and Neck Surgery (Dr Nagorsky), MCP-Hahnemann University, Philadelphia, Pa"
        }
      ]
    },
    {
      "given": "Matthew J.",
      "family": "Nagorsky",
      "sequence": "additional",
      "affiliation": [
        {
          "name": "From the Department of Pathology and Laboratory Medicine, Allegheny General Hospital, Pittsburgh, Pa (Dr Leon); and the Departments of Pathology and Laboratory Medicine (Drs Leon, Chavez, Fyfe, and Garcia) and Otorhinolaryngology\u2013Head and Neck Surgery (Dr Nagorsky), MCP-Hahnemann University, Philadelphia, Pa"
        }
      ]
    },
    {
      "given": "Fernando U.",
      "family": "Garcia",
      "sequence": "additional",
      "affiliation": [
        {
          "name": "From the Department of Pathology and Laboratory Medicine, Allegheny General Hospital, Pittsburgh, Pa (Dr Leon); and the Departments of Pathology and Laboratory Medicine (Drs Leon, Chavez, Fyfe, and Garcia) and Otorhinolaryngology\u2013Head and Neck Surgery (Dr Nagorsky), MCP-Hahnemann University, Philadelphia, Pa"
        }
      ]
    }
  ],
  "member": "3906",
  "reference": [
    {
      "key": "2021012907551643100_i1543-2165-126-2-217-b1",
      "doi-asserted-by": "crossref",
      "first-page": "155",
      "DOI": "10.1111/j.1365-2273.1978.tb00678.x",
      "article-title": "Cholesterol granuloma of the maxillary antrum.",
      "volume": "3",
      "author": "Graham",
      "year": "1978",
      "journal-title": "Clin Otolaryngol"
    },
    {
      "key": "2021012907551643100_i1543-2165-126-2-217-b2",
      "doi-asserted-by": "crossref",
      "first-page": "956",
      "DOI": "10.1177/019459989310900530",
      "article-title": "Cholesterol granulomas of the maxillary sinus presenting with nasal obstruction.",
      "volume": "109",
      "author": "Rath-Wolfson",
      "year": "1993",
      "journal-title": "Otolaryngol Head Neck Surg"
    },
    {
      "key": "2021012907551643100_i1543-2165-126-2-217-b3",
      "doi-asserted-by": "crossref",
      "first-page": "293",
      "DOI": "10.1016/0266-4356(86)90096-3",
      "article-title": "A review of maxillary sinus cholesterol granuloma.",
      "volume": "24",
      "author": "Milton",
      "year": "1986",
      "journal-title": "Br J Oral Maxillofac Surg"
    },
    {
      "key": "2021012907551643100_i1543-2165-126-2-217-b4",
      "doi-asserted-by": "crossref",
      "first-page": "630",
      "DOI": "10.1017/S0022215100105936",
      "article-title": "Cholesterol granuloma of the maxillary antrum.",
      "volume": "102",
      "author": "Gunes",
      "year": "1988",
      "journal-title": "J Laryngol Otol"
    },
    {
      "key": "2021012907551643100_i1543-2165-126-2-217-b5",
      "doi-asserted-by": "crossref",
      "first-page": "79",
      "DOI": "10.1016/S0165-5876(86)80031-3",
      "article-title": "Cholesterol crystals in the temporal bone and paranasal sinuses.",
      "volume": "11",
      "author": "Niho",
      "year": "1986",
      "journal-title": "Int J Pediatr Otorhinolaryngol"
    },
    {
      "key": "2021012907551643100_i1543-2165-126-2-217-b6",
      "doi-asserted-by": "crossref",
      "first-page": "65",
      "DOI": "10.1017/S002221510013991X",
      "article-title": "Cholesterol granuloma of the maxillary sinus: six cases from the same region.",
      "volume": "112",
      "author": "Kunt",
      "year": "1998",
      "journal-title": "J Laryngol Otol"
    },
    {
      "key": "2021012907551643100_i1543-2165-126-2-217-b7",
      "doi-asserted-by": "crossref",
      "first-page": "67",
      "DOI": "10.1227/00006123-198507000-00011",
      "article-title": "Cholesterol granuloma of the petrous apex and sphenoidal sinus: a case report.",
      "volume": "17",
      "author": "Gray",
      "year": "1985",
      "journal-title": "Neurosurgery"
    },
    {
      "key": "2021012907551643100_i1543-2165-126-2-217-b8",
      "first-page": "125",
      "article-title": "Cholesterol granuloma of the middle ear: report of 5 cases.",
      "volume": "50",
      "author": "Campos",
      "year": "1996",
      "journal-title": "Acta Otorhinolaryngol Belg"
    },
    {
      "key": "2021012907551643100_i1543-2165-126-2-217-b9",
      "doi-asserted-by": "crossref",
      "first-page": "551",
      "DOI": "10.1288/00005537-199505000-00022",
      "article-title": "Endoscopic treatment of maxillary sinus cholesterol granuloma.",
      "volume": "105",
      "author": "Marks",
      "year": "1995",
      "journal-title": "Laryngoscope"
    },
    {
      "key": "2021012907551643100_i1543-2165-126-2-217-b10",
      "doi-asserted-by": "crossref",
      "first-page": "356",
      "DOI": "10.1001/archotol.1970.00770040514010",
      "article-title": "Experimental cholesterol granuloma.",
      "volume": "91",
      "author": "Main",
      "year": "1970",
      "journal-title": "Arch Otolaryngol"
    }
  ],
  "container-title": "Archives of Pathology &amp; Laboratory Medicine",
  "original-title": [],
  "language": "en",
  "link": [
    {
      "URL": "http://meridian.allenpress.com/aplm/article-pdf/126/2/217/2728416/0003-9985(2002)126_0217_cgotms_2_0_co_2.pdf",
      "content-type": "application/pdf",
      "content-version": "vor",
      "intended-application": "syndication"
    },
    {
      "URL": "http://meridian.allenpress.com/aplm/article-pdf/126/2/217/2728416/0003-9985(2002)126_0217_cgotms_2_0_co_2.pdf",
      "content-type": "unspecified",
      "content-version": "vor",
      "intended-application": "similarity-checking"
    }
  ],
  "deposited": {
    "date-parts": [
      [
        2021,
        1,
        29
      ]
    ],
    "date-time": "2021-01-29T07:55:56Z",
    "timestamp": 1611906956000
  },
  "score": 1,
  "resource": {
    "primary": {
      "URL": "https://meridian.allenpress.com/aplm/article/126/2/217/453339/Cholesterol-Granuloma-of-the-Maxillary-Sinus"
    }
  },
  "subtitle": [],
  "short-title": [],
  "issued": {
    "date-parts": [
      [
        2002,
        2,
        1
      ]
    ]
  },
  "references-count": 10,
  "journal-issue": {
    "issue": "2",
    "published-print": {
      "date-parts": [
        [
          2002,
          2,
          1
        ]
      ]
    }
  },
  "URL": "http://dx.doi.org/10.5858/2002-126-0217-CGOTMS",
  "relation": {},
  "ISSN": [
    "1543-2165",
    "0003-9985"
  ],
  "subject": [],
  "published": {
    "date-parts": [
      [
        2002,
        2,
        1
      ]
    ]
  }
}