CLINICOPATHOLOGICAL STUDY OF NON-NEOPLASTIC LESIONS OF NASAL CAVITY AND PARANASAL SINUSES IN A TERTIARY CARE TEACHING HOSPITAL
DOI:
https://doi.org/10.22159/ajpcr.2023.v16i11.48229Keywords:
Nasal sinuses, Non-neoplastic, Polyps, Mucormycosis, COVIDAbstract
Objective: A variety of non-neoplastic lesions involving the nasal cavity (NC) and paranasal sinuses (PNS) are encountered in clinical practice. The clinical features, symptoms, and advanced imaging technique help to reach a provisional diagnosis but histopathological examination remains the mainstay of final definitive diagnosis. There is a lack of studies that exclusively cover non-neoplastic lesions of sinonasal region. Hence, this study was done with the aim of examining the clinicopathological features of various non-neoplastic lesions of NC and PNS.
Methods: The formalin-fixed specimens of polypectomy/biopsy were received with complete clinical and radiological features in the department of pathology. Routine gross examination and required number of sections were taken and stained with hematoxylin and eosin stain. Periodic acid Schiff’s was used wherever necessary.
Results: Histologically, maximum number of cases were of inflammatory polyp (IP) (57%), followed by Allergic polyp (AP) (18%) and Invasive Fungal Sinusitis-Mucormycosis (17%). Mucormycosis was found in patients who have recovered from COVID along with a steroid intake history or had diabetes mellitus or had multiple comorbidities along with COVID recovery and steroid intake.
Conclusion: Among the non-neoplastic lesion, IP is the most common lesion followed by AP. The significant number of mucormycosis cases was seen due to the ongoing COVID pandemic and liberal use of corticosteroids in the treatment.
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References
Mane SA. Clinicopathological study of sinonasal masses. Ann Pathol Lab Med 2017;4:261-7.
Birare SD, Chaudhari AS. Clinicopathological study of lesions of nasal cavity and paranasal sinuses-a two year study. IP J Diagn Pathol Oncol 2021;6:259-66.
Lingen MW, Kumar V. Head and Neck. In: Kumar V, Abbas AK, Fausto N, editors. Robbin’s and Cotran Pathologic Basis of Disease. 7th ed. Philadelphia: Elsevier Inc.; 2005. p. 783.
Kumar A. Lesions of nasal cavity, paranasal sinuses and nasopharynx: A clinicopathological study. Int J Res Rev 2022;4:1302-6.
Bateman ND, Fahy C, Woolford TJ. Nasal polyps: Still more questions than answers. J Laryngol Otol 2003;117:1-9. doi: 10.1258/002221503321046577, PMID 12590849
Parajuli S, Tuladhar A. Histomorphological spectrum of masses of the nasal cavity, paranasal sinuses and nasopharynx. J Pathol Nepal 2013;3:351-5. doi: 10.3126/jpn.v3i5.7857
Bakari A, Afolabi OA, Adoga AA, Kodiya AM, Ahmad BM. Clinico-pathological profile of sinonasal masses: An experience in national ear care center Kaduna, Nigeria. BMC Res Notes 2010;3:186. doi: 10.1186/1756-0500-3-186, PMID 20618972
Kulkarni A, Shetty A, Pathak P. Histopathological study of lesions of nasal cavity and paranasal sinuses. Indian J Pathol Oncol 2020;7:88-93.
Kulkarni AM, Mudholkar VG, Acharya AS, Ramteke RV. Histopathological study of lesions of nose and paranasal sinuses. Indian J Otolaryngol Head Neck Surg 2012;64:275-9.
Zafar U, Khan N, Afroz N, Hasan SA. Clinicopathological study of non-neoplastic lesions of nasal cavity and paranasal sinuses. Ind J Pathol Microbiol 2008;51:26-9. doi: 10.4103/0377-4929.40386, PMID 18417845
Shah H, Bhalodiya N. Scenario of fungal infection of nasal cavity and paranasal sinuses in Gujarat: A retrospective study. Gujarat Med J 2014;69:27-31.
Kumar A, Sood N, Gautam R, Ahlawat S, Nausaran K. Histopathological analysis of lesion of nasal cavity, paranasal sinus and nasopharynx-a clinical study. J Adv Med Dent Sci Res 2017;5:90-2.
Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. European position paper on rhinosinusitis and nasal polyps 2020. Rhinology 2020;58:1-464. doi: 10.4193/Rhin20.600, PMID 32077450
Parmar NJ, Jethwani DP, Dhruva GA. Histopathological study of nasal lesions: 2 years study. Int J Res Med Sci 2018;6:1217-23. doi: 10.18203/2320-6012.ijrms20181271
Guarner J, Brandt ME. Histopathologic diagnosis of fungal infections in the 21st century. Clin Microbiol Rev 2011;24:247-80. doi: 10.1128/ CMR.00053-10, PMID 21482725
Rokade V, Shinde KJ, More GR. Clinicopathological profile of sinonasal masses-a tertiary care centre study in rural India. Int J Otorhinolaryngol Head Neck Surg 2020;6:1821-6. doi: 10.18203/ issn.2454-5929.ijohns20204182
Singh V. Fungal rhinosinusitis: Unravelling the disease spectrum. J Maxillofac Oral Surg 2019;18:164-79. doi: 10.1007/s12663-018- 01182-w, PMID 30996535.
Sharma S, Grover M, Bhargava S, Samdani S, Kataria T. Post coronavirus disease mucormycosis: A deadly addition to the pandemic spectrum. J Laryngol Otol 2021;135:442-7. doi: 10.1017/S0022215121000992, PMID 33827722
Singh AK, Singh R, Joshi SR, Misra A. Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India. Diabetes Metab Syndr 2021;15:102146. doi: 10.1016/j.dsx.2021.05.019, PMID 34192610
Chander J, Kaur M, Singla N, Punia RP, Singhal SK, Attri AK, et al. Mucormycosis: Battle with the deadly enemy over a five-year period in India. J Fungi (Basel) 2018;4:46. doi: 10.3390/jof4020046, PMID 29642408
Laudien M. Orphan diseases of the nose and paranasal sinuses: Pathogenesis-clinic-therapy. GMS Curr Top Otorhinolaryngol Head Neck Surg 2015;14:Doc04. PMCID PMC4702053
Prakash H, Ghosh AK, Rudramurthy SM, Singh P, Xess I, Savio J, et al. A prospective multicenter study on mucormycosis in India: Epidemiology, diagnosis, and treatment. Med Mycol 2019;57:395-402. doi: 10.1093/mmy/myy060, PMID 30085158
Patel A, Kaur H, Xess I, Michael JS, Savio J, Rudramurthy S, et al. A multicentre observational study on the epidemiology, risk factors, management and outcomes of mucormycosis in India. Clin Microbiol Infect 2020;26:944.e9-15. doi: 10.1016/j.cmi.2019.11.021, PMID 31811914
Sharma AK, Nagarkar NM, Gandhoke CS, Sharma S, Juneja M, Kithan ZM et al. Rhinocerebral mucormycosis (RCM): To study the clinical spectrum and outcome of 61 cases of RCM managed at a tertiary care center in India. Surg Neurol Int 2023;14:15.
Dasgupta A, Ghosh RN, Mukherjee C. Nasal polyps-histopathologic spectrum. Indian J Otolaryngol Head Neck Surg 1997;49:32-7. doi: 10.1007/BF02991708, PMID 23119246
Arora V, Nagarkar NM, Dass A, Malhotra A. Invasive rhino-orbital aspergillosis. Indian J Otolaryngol Head Neck Surg 2011;63:325-9. doi: 10.1007/s12070-011-0240-8, PMID 23024936
Urs AB, Singh H, Nunia K, Mohanty S, Gupta S. Post endodontic aspergillosis in an immunocompetent individual. J Clin Exp Dent 2015;7:e535-9. doi: 10.4317/jced.52247, PMID 26535103
Martinez D, Burgueño M, Forteza G, Martin M, Sierra I. Invasive maxillary aspergillosis after dental extraction. Case report and review of the literature. Oral Surg Oral Med Oral Pathol 1992;74:466-8. doi: 10.1016/0030-4220(92)90297-4, PMID 1408022
Peral-Cagigal B, Redondo-González LM, Verrier-Hernández A. Invasive maxillary sinus aspergillosis: A case report successfully treated with voriconazole and surgical debridement. J Clin Exp Dent 2014;6:e448-51. doi: 10.4317/jced.51571, PMID 25593673
Banerji A, Piccirillo JF, Thawley SE, Levitt RG, Schechtman KB, Kramper MA, et al. Chronic rhinosinusitis patients with polyps or polypoid mucosa have a greater burden of illness. Am J Rhinol 2007;21:19-26. doi: 10.2500/ajr.2007.21.2979, PMID 17283555
Pal R, Singh B, Bhadada SK, Banerjee M, Bhogal RS, Hage N, et al. COVID‐19‐associated mucormycosis: An updated systematic review of literature. Mycoses 2021;64:1452-9. doi: 10.1111/myc.13338, PMID 34133798
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