The correlation of clinical measures with the histopathological findings in nasal polyposis

Abstract

Objective: The aim of this study was to outline the histopathological findings of nasal polyposis and to investigate whether these findings were associated with the severity of the disease and co-existing morbidities as well as hematological parameters. Methods: Seventy-seven nasal polyposis (52 male, 25 female; mean age: 46.99±13.27 years) patients who underwent endoscopic sinus surgery between 2007 and 2011 were included in the study. Data was extracted from medical files and endoscopy scores, and Lund-Mackay Computed Tomography scores, Nasal Obstruction Symptom Evaluation (NOSE) scales, presence of allergy and asthma, and blood eosinophil levels were noted. Correlation of this data with histopathological findings (such as basement membrane thickness, goblet cell hyperplasia, subepithelial edema, submucous gland formation, eosinophilic infiltration, lymphocytic infiltration and polymorphonuclear leukocyte infiltration) was analyzed. Results: Analysis of our findings yielded that the only statistically significant finding was the correlation of eosinophilic infiltration with the blood eosinophil level (p

Keywords

• Nasal polyposis, histopathology, eosinophilia, severity, correlation

Nazal polipoziste histopatolojik bulgular ile klinik ölçütler ile arasındaki ilişki

Öz

Amaç: Bu çalışmada nazal polipozisli hastalarda histopatolojik bulguların detaylı olarak tanımlanarak bu bulguların hastalığın şiddeti ve astım, alerji ve kan eozinofil düzeyi gibi bazı eşlik eden faktörlerle ilişkisinin araştırılması amaçlanmıştır. Yöntem: Çalışmada 2007-2011 yılları arasında endoskopik sinüs cerrahisi uygulanan yetmiş-yedi nazal polipozisli hastanın (52 erkek, 25 kadın; yaş ortalaması: 46.99±13.27) verileri incelenmiştir. Yapılan retrospektif değerlendirmede endoskopik skorları, Lund-Mackay bilgisayarlı tomografi skorları, nazal obstrüksiyon semptom değerlendirme skalaları, alerji ve astım varlığı ve kan eozinofil düzeyleri kaydedilmiştir. Bu veriler histopatolojik bulgularla (bazal membran kalınlığı, goblet hücre hiperplazisi, subepitelyal ödem, submukozal gland formasyonu, eozinofilik infiltrasyon, lenfositik infiltrasyon ve polimorfonükleer infiltrasyon) karşılaştırılmıştır. Bulgular: Bulgular değerlendirildiğinde eozinofil infiltrasyonu ve kan eozinofil düzeyleri arasında istatistiksel açıdan anlamlı bir ilişki saptanmıştır (p

Anahtar Kelimeler

• Nazal polipozis, histopatoloji, eozinofili, şiddet, korelasyon

Kaynakça

1. Bachert C, Hörmann K, Mösges R, et al. An update on the diag- nosis and treatment of sinusitis and nasal polyposis. Allergy 2003; 58:176–91.
2. Ardehali MM, Amali A, Bakhshaee M, Madani Z. Histopathologic characteristics of inferior turbinate vs ethmoidal polyp in chronic rhinosinusitis. Ann Diagn Pathol 2011;15:233–6.
3. Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT. Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg 2004;130:157–63.
4. Malm L. Assessment and staging of nasal polyposis. Acta Otolaryngol 1997;117:465–7.
5. Lund VJ, Kennedy DW. Staging for rhinosinusitis. Otolaryngol Head Neck Surg 1997;117:S35–40.
6. Dhong HJ, Kim HY, Cho DY. Histopathologic characteristics of chronic sinusitis with bronchial asthma. Acta Otolaryngol 2005; 125:169–76.
7. Ardehali MM, Amali A, Bakhshaee M, Madani Z, Amiri M. The comparison of histopathological characteristics of polyps in asth- matic and nonasthmatic patients. Otolaryngol Head Neck Surg 2009;140:748–51.
8. Alatas N, Baba F, San I, Kurcer Z. Nasal polyp diseases in allergic and nonallergic patients and steroid therapy. Otolaryngol Head Neck Surg 2006;135:236–42.

9. Larsen P, Tos M, Anatomic site of origin of nasal polyps: endo- scopic nasal and paranasal sinus surgery as a screening method for nasal polyps in autopsy material, Am J Rhinol 1996;10:210–6.
10. Watanabe K, Komatsuzaki A. Ultrastructural findings of capillar- ies in nasal polyps. Rhinology 1992;30:49–56.
11. Settipane GA, Lund V.J., Bernstein, J.M., Tos, M., Nasal polyps: epidemiology, pathogenesis and treatment. Providence, Rhode Island: Oceanside Publications, Inc.; 1997. p. 9.
12. Nakayama T, Yoshikawa M, Asaka D, et al. Mucosal eosinophilia and recurrence of nasal polyps – new classification of chronic rhi- nosinusitis. Rhinology 2011;49:392–6.
13. Garín L, Armengot M, Alba JR, Carda C. Correlations between clinical and histological aspects in nasal polyposis. Acta Otorrinolaringol Esp 2008;59:315–20.
14. Shen Y, Pan C, Tang X, et al. Significance of Interleukin-17A in patients with nasal polyposis. Asian Pac J Allergy Immunol 2011; 29:169–75.
15. Cheng W, Zheng C, Tian J, Shi G. T helper cell population and eosinophilia in nasal polyps. J Investig Allergol Clin Immunol 2007;17:297–301
16. Robinson S, Douglas R, Wormald PJ. The relationship between atopy and chronic rhinosinusitis. Am J Rhinol 2006;20:625–8.
17. Scavuzzo MC, Fattori B, Ruffoli R, et al. Inflammatory mediators and eosinophilia in atopic and nonatopic patients with nasal poly- posis. Biomed Pharmacother 2005;59:323–9.
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21. Please cite this article as: Altın Kule Z, Deveci HS, Kule M, Erden Habeflo¤lu T, Somay A, Gürsel AO. The correlation of clinical measures with the
22. histopathological findings in nasal polyposis. ENT Updates 2015;5(1):1–8.