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Incidence of neoplasia in patients with clinically suspicious nasal lesions and the value of computed tomography imaging in diagnosis

Published online by Cambridge University Press:  16 February 2015

P Asimakopoulos ,
I Hathorn ,
H Monaghan  and
A T Williams
P Asimakopoulos*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University of Edinburgh Hospitals, Scotland, UK
I Hathorn
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University of Edinburgh Hospitals, Scotland, UK
H Monaghan
Affiliation:
Department of Pathology, Edinburgh Royal Infirmary, Scotland, UK
A T Williams
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University of Edinburgh Hospitals, Scotland, UK
*
Address for correspondence: Dr Panagiotis Asimakopoulos, Department of Otolaryngology, Head and Neck Surgery, Aberdeen Royal Infirmary, Forresterhill Road, Aberdeen AB25 2ZN, Scotland, UK E-mail: panagiotis.asimakopoulos@nhs.net
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Abstract

Background:

There is no consensus as to whether all routine bilateral polypectomy specimens should be sent for formal histopathological diagnosis to exclude underlying neoplastic pathology. This study assessed the necessity for histopathological investigation as routine practice in cases of bilateral and unilateral nasal lesions by estimating the incidence of unexpected pathologies. It also evaluated the ability of computed tomography to predict histopathological diagnosis in patients with unilateral nasal lesions.

Methods:

A retrospective analysis was conducted of 98 patients undergoing nasal polypectomy over a 12-month period.

Results:

Five of 23 patients with a unilateral lesion on nasendoscopy had inverted papillomas on histopathological examination. None of the 75 patients with clinically bilateral lesions on nasendoscopy showed evidence of neoplasia on histopathological examination. Patients with inverted papillomas had significantly lower total Lund–Mackay scores than those with bilateral polyps. Asymmetry scores of inverted papilloma patients were significantly higher compared to both bilateral and unilateral polyps patients.

Conclusion:

The results suggest that histopathological diagnosis is only necessary in unilateral lesion patients as no unexpected histopathological diagnoses were made in bilateral lesion patients. Computed tomography imaging may have a role in predicting histopathological diagnosis by demonstrating asymmetry and less overall sinus opacification in patients with neoplastic lesions.

Keywords

Paranasal Sinus NeoplasmsPapilloma, InvertedNasal PolypsRadiography
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 3 , March 2015 , pp. 254 - 260
Copyright
Copyright © JLO (1984) Limited 2015 

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