Discrepancies between histopathological and clinical diagnosis of unilateral nasal polyp (original) (raw)
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Clinical and histopathological correlation of nasal polyps: are there any surprises?
… & Allied Sciences, 2001
Clinical and histopathological correlation of nasal polyps: are there any surprises? Nasal polypectomy is a common operation. There is debate about whether all nasal polyps removed at operation should be sent for histopathological examination. To investigate this, a prospective study was performed to check the correlation of clinical and histopathological examination. Three hundred and forty-four nasal polypectomy specimens during the period from September 1997 to September 1999 were sent for histopathological diagnosis, with the clinical diagnosis documented on the pathology form. The clinical diagnosis was then correlated with the histological diagnosis. Three hundred and twenty-eight specimens were diagnosed as in¯ammatory polyps and 16 as tumours, of which seven were malignant. There was a good correlation between the clinical and histological ®ndings in 340 cases. There was disagreement between the forms and reports in four cases. When the notes were consulted, three cases had forms that were incorrectly ®lled in. There was only one unsuspected case of inverted papilloma in a polyp specimen, which looked like a benign in¯ammatory polyp. This study indicates there is a 99.7% correlation between clinical and histopathological diagnosis. Keywords nasal polyps histology inverted papilloma
Patterns, Presentations and Prognosis of Nasal Polyps
Indian Journal of Otolaryngology and Head & Neck Surgery, 2017
Few studies have documented the characteristic features of nasal polyps in the developing countries. In this study, we described the patterns, presentations and prognosis of nasal polyps seen in clinical setting, with a view to improve our understanding of its clinical and epidemiological characteristics. The study was a 10-year retrospective analysis of histologically-confirmed nasal polyps seen between January 2006 and December 2015. Records of patients with intranasal masses were retrieved from our hospital’s records department, clinics, wards and theatre suites. Those with nasal polyps were recruited into the study. The results were descriptively analyzed using SPSS statistical soft ware package version 10. There were 84 patients with intranasal masses seen within the reviewed period. Of this, 52 (61.9%) were histologically-confirmed nasal polyps. There were 22 males and 30 females. Their age ranges from 16 to 69 years. The most frequent symptom is nasal obstruction occurring in 76.9% of the cases. None of the patients had epistaxis. Thirty-one (59.6%) were associated with various complications either singly or multiple (Table 1). All (100%) were treated with conventional forceps excision. Eleven (21.2%) of them had recurrence between 3 and 5 years after surgery. None of the polyps or their recurrence exhibited malignant transformation. Nasal polyp is the most common intranasal mass seen in clinical practice. Its rarity in children and propensity for recurrence are reaffirmed. Although, recurrence is a major prognostic challenge, nasal polyp does not exhibit malignant transformation.Table 1Showing frequency distribution of the presenting complaints, radiological findings and complicationsVariableFrequency% Presenting complaints Nasal obstruction4076.9 Snoring3261.5 Visible nasal mass2548.1 Nasal discharge (watery, mucous, purulent)1426.9 Paroxysmal sneezing1019.2 Loss of sense of smell917.3 Headache815.4 Facial pain59.6Radiological findings Opacification of ethmoid and maxillary sinuses4688.5 Soft tissue opacity in the nasal cavity4178.9 Soft tissue opacity in the nasopharynx2650.0 Dome-shaped soft tissue opacity in the maxillary sinus1223.1 Fluid level in the maxillary sinus611.5 Clear paranasal sinuses47.7Complications Acute rhinosinusitis59.6 Epiphora611.5 Anosmia917.3 Obstructive sleep apnoea2853.8Open in a separate windowSome patients have multiple complaints/radiological findings/complications
Study of Nasal Polyps in a Tertiary Care Hospital
International Journal of Research in Pharmaceutical Sciences, 2020
Nasal polyps are macroscopic oedematous lesions in the nose openings are the most common problem of the patients. Main causes of the polyps are due to in lammatory conditions and allergy. An association with asthma, aspirin sensitivity and cystic ibrosis was seen in the population. The main objectives of medical treatment of nasal polyps are to eliminate or reduce the size of the polyps thereby improving the symptoms of rhinitis and breathing. The clinical characteristics and treatment pattern among the 125 patients having nasal polyps was analyzed by a retrospective, observational study using patient’s medical records and hospital data management system. Males predominated in thepresent study (64.8%)andmajority of thepatientswere in the age group of 41-60 years (44%). Most of the patients suffered from sinonasal polyposis (76.8%)with themain symptombeingnasal block (88.8%). Most of thepolyps were of the in lammatory origin (53.6%). Asthma and rhinitis were observed in 11% patients....
The Efficiency of Routine Histopathological Examination for Bilateral Nasal Polyposis
Ear, Nose & Throat Journal
The necessity to routinely carry out histopathologic examinations of surgically removed polyps in patients with chronic rhinosinusitis with bilateral nasal polyps (CRSwNP) is uncertain. The aim of this study was to describe the histopathology of polyps from a large series of patients who underwent endoscopic sinus surgery for CRSwNP and the rate of neoplasms. This is a retrospective study of the histopathological result of all patients with CRSwNP who underwent functional endoscopic nasal surgery and in whom histologic examination was performed, from 2006 to 2015, in a tertiary medical center. Data on demographics and whether a nasal lesion was suspected for neoplasm prior to surgery were analyzed. Two hundred thirty-five patients underwent bilateral nasal polypectomy and histopathologic examinations of the surgical specimens. The rate of neoplasms in nonsuspicious cases was 2.3% (5 cases) and all were inverted papilloma. To conclude, inverted papilloma and other neoplasms are consi...
Journal of Evolution of medical and Dental Sciences, 2014
INTRODUCTION: Sino nasal polyps are a multifactorial disease with varied etiology. Till date etiology of nasal polyps is unclear and no single theory adequately explains the etiology. OBJECTIVES: To study clinically the etiology of sino nasal polyps. To confirm the diagnosis of sino nasal polyps by histopathology. MATERIALS AND METHODS: Data was analyzed in patients of sino nasal polyps with clinical History and anterior rhinoscopy was performed. All these patients with sino nasal polyps were investigated with total serum IgE, Absolute eosinophil count and Skin prick test. These polyps were excised by FESS and the excised specimen was sent for Histopathological examination. Exact nature of sino nasal polyps and final diagnosis was given after Histopathological confirmation. CONCLUSION: 1. Etiology of sino nasal polyp is to be confirmed by clinical investigations of total serum IgE, Absolute eosinophil count and Skin prick test. 2. Total serum IgE, Absolute eosinophil count and Skin ...
An Overview of Nasal polyps and its pathogenesis, commodities and treatment
IOSR Journals , 2019
The seditionary noncancerous extensions of nasal and paranasal mucosa are called nasal polyps affecting up to 4% of population. They arise from the long-term inflammation of the mucosa of the nasal cavity leading to changes of olfactory, rhinorhea, nasal blockage. If nasal polyps presents with at least two or more of the following symptoms persistently occur for 12 weeks or more, nasal discharge occurring anteriorly or runny nose, post nasal dripping, blockage of nasal cavity. Blockage of nose is the chief complain of patients with nasal polyps that is consistent with variety in severity depending on the size of the polyps, With the help of anterior Rhinoscopy or endoscopy polyps, hyperemia of the mucosa of nasal cavity, narrowing of the nasal pathway could be noticed. Risk Factors of nasal polyps include Asthma, cystic fibrosis, AERD, allergic fungal sinusitis. Treatment options includes with topical intranasal steroids. Glucocorticosteroids are the best to treat nasal polyps. In case of patients with AERD daily high dosage of acetylsalicylic acid have showed reduced the polyps recurrence and sinal infections, use of oral and topical corticosteroids have been reduced and also microsmia got improved. The aim of the contemporary study was to review the available literature regarding the etiologic factors, causative agents, diagnosis and treatment options of nasal polyps.
Is routine histopathological analysis of nasal polyposis specimens necessary?
European Archives of Oto-Rhino-Laryngology, 2011
Our objective is to evaluate the incidence of unexpected pathologies in routine nasal polyposis specimens and necessity for histopathological evaluation of nasal polyps. A retrospective chart review of all patients who underwent nasal polyposis surgery between January 2004 and June 2010 were reviewed. The patients were divided into two groups. Group 1 consisted of patients with bilateral nasal polyposis. Group 2 consisted of patients with unilateral nasal polyposis. One hundred and seventeen patients (81 male, 36 female) were involved in this study. The mean age was 44.9 § 17.7 years, ranging between 18 and 72 years. Group 1 consisted of bilateral nasal polyposis specimens. Eighty-Wve patients were identiWed with bilateral nasal polyposis. From these 85 patients, no specimens present any evidence of occult pathology on histopathological examination. Group 2 consisted of unilateral nasal polyposis specimens. There were two cases of allergic fungal sinusitis, two of inverting papilloma, one of mucocele, one of plasmacytoma, one of hemangioma, one of esthesioneuroblastoma, and one of schwannoma. Final histopathology of the remaining 23 patients was consistent with inXammation and/or nasal polyposis. We think that in cases of unilateral polyps histopathological examination of the entire material is mandatory. However, routine histological examination of bilateral nasal polyposis may possibly not be necessary in cases where the clinical assessment very clearly has not disclosed any unusual or suspicious signs.
Unani perspective of Nasal Polyps (Bawaseer ul Anf): A literary Review
The Unani System of Medicine is one of the ancient systems of medicine based on the concept of equilibrium and balance of Akhlat (natural body humours). When these humours are normal in quantity, quality and they mixed well together prevail human remains healthy. The imbalance or irregular distribution causes disease. According to Unani literature, Bawaseer al Anf is a growing of excess lahem (muscle) in the nasal cavity which is caused by the accumulation of Ghaleez khilt (thick humour) infiltrated from the anterior part of the brain produces nasal obstruction and discharge from the nose. The features of Bawaseer al Anf correspond with that of nasal polyp in modern medicine. Nasal polyp is a mass of the nasal cavity which are frequently a pedunculated, hypertrophied and oedematous mucosa from the mucous membranes of the nose and paranasal air sinuses. This review aims to highlight the concept of Bawaseer al Anf with special reference to nasal polyps and its management in the Unani system of medicine. Details and facts on nasal polyps were gathered from the Unani classical texts, published journals, PubMed, google scholar, research gate by using words like nasal polyps, Bawaseer al Anf, nasal discharge, nasal obstruction, nasal allergy, nasal voice and quality of life. Then the data were analyzed and summarized.
Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 2018
Based on the presence of nasal polyps (NP) on endoscopy, chronic rhinosinusitis (CRS) has been clinically divided into CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). While the majority of cases are bilateral, NPs can present unilaterally. CRS with unilateral NP (UNP) is the most common presentation in unilateral polyposis, but there have been few studies on UNP. Lee et al have shown that UNP had more favorable objective surgical outcomes than bilateral disease. This article is protected by copyright. All rights reserved.
Unilateral nasal polyposis: clinical presentation and pathology
American Journal of Otolaryngology, 2008
Objectives: The aim of this study is to determine the clinical presentation and pathology of unilateral nasal polyposis (UNP). Study design: Retrospective chart review. Methods: A retrospective analysis was completed on 301 consecutive patients with nasal polyposis that underwent functional endoscopic sinus surgery from 1995 to 2004. Of the charts reviewed, 46 patients were identified with UNP. In this group, there were 28 males and 18 females with a mean age at presentation of 34.85 years. Pathologic diagnosis was not available for 2 patients, so there were 44 UNP patient records for analysis. Presenting symptoms, surgical findings, and pathology were analyzed. Results: All 44 patients underwent surgical management for their symptoms, and specimens were sent for pathologic evaluation. There were 17 cases of chronic rhinosinusitis, 15 of allergic fungal sinusitis, 7 of inverting papilloma, 2 of squamous cell carcinoma, 1 of esthesioneuroblastoma, 1 of mucocele, and 1 of human papilloma virus polyp-type papilloma. The only presenting symptom that correlated with the presence of inverted papilloma or neoplastic process in our patients with UNP was epistaxis. Conclusions: Chronic rhinosinusitis, allergic fungal sinusitis, inverting papilloma, and other neoplasms account for most UNP cases and must be considered when a patient presents with symptoms of unilateral polyps. A careful history and endoscopic examination play a key role in identifying possible disease processes and proper management.