: Sinonazal kitlelerde 6 yıllık histopatoloji sonuçlarımız

Öz

Amaç: Bu çalışmada klinikte bilateral tutulumla karşımıza çıkan sinonazal kitleli olgular ile tek taraflı tutulumu olan olguların yaş, cinsiyet ve histopatolojik tanılar açısından karşılaştırılması amaçlanmıştır. Material ve Method: Ocak 2012 ile Aralık 2017 tarihleri arasında sinonazal kitle nedeniyle insizyonel veya eksizyonel biyopsi yapılan 506 hastanın patoloji sonuçları incelendi. Vakaların yaş, cinsiyet ve yıllara göre dağılım oranları ile tek taraflı veya bilateral tutulum oranları değerlendirildi. Bulgular: Toplam 549 hastanın yaş ortalaması 40.12 ± 14.31 idi. En sık görülen patolojik tanının nazal polip olduğu görüldü (% 71). Histopatolojik tanıların %10.6'sı benign,% 0.9'u malign ve % 88.5'i neoplastik olmayan grupta olacak şekilde dağıldığı görüldü. Sağ taraf tutulumu %15.7, sol taraf tutulumu % 17.7, bilateral tutulum % 66.7 idi. Neoplastik olmayan kitle grubundaki hastalarda diğer tanı gruplarına göre anlamlı derecede daha fazla bilateral tutulum olduğu görüldü(p = 0.001). Sonuç: Sinonasal kitleler arasında en sık görülen histopatolojik tanı nazal poliplerdir. Nazal polipler sıklıkla bilateral olmakla birlikte tek taraflı olarak da görülebilir. Tek taraflı sinonasal kitlelerde malignite olabileceğinden biyopi ile ayırıcı tanı ortaya konmalıdır.

Anahtar Kelimeler

• nazal polip
• inverted papillom
• histopatoloji
• maligniteler

Our histopathology results of 6 years in sinonasal masses

Öz

Purpose: In this study, it was aimed to compare patients with bilateral sinonasal mass and those who have unilateral sinonasal mass in terms of age, gender and histopathological diagnoses. Material and Method: The histopathological results of 549 patients who underwent incisional / excisional biopsy or sinonasal surgery in our clinic between January 2012 and December 2017 were examined. All histopathological diagnoses were divided into 3 groups as benign, malign and non-neoplastic. Distribution rates of cases with unilateral involvement and cases with bilateral involvement were evaluated by age, gender and years. Results: The average age of 549 patients was 40.12 ± 14.31.The most common histopathological diagnosis was nasal polyp (71%). It was observed that 10.6% of histopathological diagnoses were benign, 0.9% malign and 88.5% non-neoplastic. Right sided involvement was observed in 15.7% of the patients, left sided involvement was in 17.7%, and bilateral involvement was observed in 66.7% of the patients. The group which includes patients with non-neoplastic mass was found to have significantly more bilateral involvement than other groups (p = 0.001). Conclusion: The most common histopathological diagnosis of sinonasal masses is nasal polyps. Nasal polyps are often bilateral but they can also be unilateral. Unilateral sinonasal masses can be malign, therefore differential diagnosis should be made by biopsy.

Anahtar Kelimeler

• nasal polyp
• inverted papilloma
• histopathology
• malignancies

Kaynakça

1. Reference1 Kahveci OK, Duran A, Miman MC. Burun İçi Kitlelerde Histopatolojik Sonuçlarımız; 6 Yıllık Retrospektif Çalışma. J Clin Anal Med. 2012;3(3):289-92.
2. Reference2 Lee JY, Byun JY, Shim SS, Lee SW . Outcomes after endoscopic sinus surgery for unilateral versus bilateral chronic rhinosinusitis with nasal polyposis. Am J Rhinol Allergy. 2010;24(3):83-86.
3. Reference3 Hofer MJ, Rohlfs J, Teymoortash A, Pagenstecher A. 62-year-old female with an intranasal mass extending into the lamina cribrosa.Brain Pathol. 2013;23(1):105-8.
4. Reference4 Cingi C, Demirbas D, Ural A. Nasal polyposis: an overview of differential diagnosis and treatment. Recent Pat Inflamm Allergy Drug Discov. 2011;5(3):241-52.
5. Reference5 Settipane GA. Epidemiology of nasal polyps. Allergy Asthma Proc. 1996;17: 231- 6. (PMID: 8922141).
6. Reference6 Drake-Lee AB. Nasal Polyps. In: Derr AG, Mackay IS, Bull TR, eds. Scott-Brown’s Otolaryngology: Rhinology, 6th ed. Oxford: Butterworth-Heinemann; 1997;1-15.
7. Reference7 Habeşoğlu TE, Habeşoğlu M, Toros ZS, Naiboğlu B, Sürmeli M, Egeli E. Tek taraflı sinonazal polipoid kitlelerde histopatoloji ve neoplastik hastalık için risk faktörleri. Göztepe Tıp Dergisi. 2010; 25(2):78-81.
8. Reference8 Agarwal M, Policeni B. Sinonasal Neoplasms. Semin Roentgenol. 2019;54(3):244-57. doi: 10.1053/j.ro.2019.03.001.

9. Reference9 Katori H, Nozawa A, Tsukuda M. Histopathological parameters of recurrence and malignant transformation in sinonasal inverted papilloma. Acta Otolaryngol. 2006;126: 214-18.
10. Reference10 Ertugrul S. Origin of polyps and accompanying sinonasal pathologies in patients with antrochoanal polyp: Analysis of 22 patients. North Clin Istanb. 2018;6(2):166-70. doi: 10.14744/nci.2018.87513.
11. Reference11 Gupta R, Moupachi SS, Poorey VK. Sinonasal masses: a retrospective analysis. Indian J Otolaryngol Head Neck Surg. 2013;65(1):52-6. doi: 10.1007/s12070-012-0602-x.
12. Reference12 Iziki O, Rouadi S, Abada RL, Roubal M, Mahtar M. Bilateral antrochoanal polyp: report of a new case and systematic review of the literature. J Surg Case Rep. 2019;20;(3):rjz074. doi: 10.1093/jscr/rjz074.
13. Reference13 Basu SK, Bandyopadhyay SN, Bora H. Bilateral antrochoanal polyps. J Laryngol Otol. 2001;115(7):561-62.
14. Reference14 Yilmaz YF, Titiz A, Ozcan M, Tezer MS, Ozlugedik S, Unal A. Bilateral antrochoanal polyps in an adult: a case report. B-ENT. 2007;3(2):97-9.