scholarly journals Different Faces of Sinonasal Mass Lesions

2021 ◽  
Vol 28 (3) ◽  
pp. 193-197
Author(s):  
Devika T ◽  
Shubha P Bhat ◽  
Vadisha Srinivas Bhat ◽  
Rajeshwary Aroor ◽  
Satheesh Kumar Bhandary B ◽  
...  

Introduction Mass in the nasal cavity presents with a wide range of symptoms, when a presumptive diagnosis is often made with the help of imaging and endoscopy. This study focussed on correlating clinical diagnosis with the histopathological diagnosis so that appropriate treatment can be offered to improve the quality of life of the patient. Materials and Methods The study included 120 cases who presented with symptoms and signs of mass in the nasal cavity, undergoing surgery or diagnostic biopsy. They were evaluated with a detailed history and clinical examination, diagnostic nasal endoscopy, and relevant radiological investigations. Histopathological examination of the biopsy of the excised specimen was performed by Haematoxylin and Eosin stain. Special stains and Immunohistochemistry (IHC) were performed whenever indicated. The clinical diagnosis was correlated with histopathological diagnosis. Results Nasal obstruction was the most frequent symptom followed by nasal discharge. Non-neoplastic lesions made up 85% of cases, while16% of cases were proved as neoplastic lesions. Among neoplastic lesions, 7% were benign, and 9% were malignant.  The inflammatory polyp was the most common non-neoplastic lesion. Fischer's exact test showed a correlation between clinical diagnosis and histopathological diagnosis. Non-neoplastic lesions were common in the 4th decade of life; benign lesions were common in the 3rd decade of life, while malignant lesions were common in the 5th decade of life. Conclusion Sinonasal masses present with overlapping clinical features, and sometimes the definite diagnosis is possible only by histopathological examination of the specimen. However, in the presence of characteristic clinical features, accurate clinical diagnosis is possible in most cases, and appropriate treatment can be performed without delay, pending histopathological examination.

Author(s):  
Belure Gowda P. R. ◽  
Vinay Kumar M. V.

<p class="abstract"><strong>Background:</strong> Masses in sino nasal cavity presents with wide range of complaints like nasal obstruction, nasal discharge, epistaxis, headache, swelling in and around the nose, through clinical examination, rigid nasal endoscopy and by use of advanced imaging technique computerized tomography (CT), magnetic resonance imaging (MRI) of nose and paranasal sinuses. Presumptive diagnosis is often made. However, it is a careful histopathological examination which divides the nature of any particular lesion, like neoplastic benign or malignant or  non-neoplastic and inflammatory which makes possible to implement correct and timely intervention, which is a major dividing factor for better prognosis.</p><p class="abstract"><strong>Methods:</strong> A total of 100 cases of nasal polyps were studied by the department of ENT at Hassan institute of medical sciences, Hassan during a period of 1 year from January 2019 to January 2020. They were treated surgically by endoscopic excision, lateral rhinotomy or by radical surgery. All the excised masses were sent for histopathological examination to determine their final diagnosis.</p><p class="abstract"><strong>Results:</strong> The middle age group of 21 to 30 years was the most common age group affected with more male predominance. Nearly 85% of the cases were non-neoplastic. The most common presentation was nasal obstruction with ethmoidal sinus being the commonest sinuses seen in the present study.</p><p class="abstract"><strong>Conclusions:</strong> Polypoid lesions in the nasal cavity and paranasal sinuses may range widely from benign to malignant affecting all the ages. Common nasal lesions were seen in age group 21-30 years and maximum lesions were non- neoplastic.</p>


2014 ◽  
Vol 21 (01) ◽  
pp. 191-196
Author(s):  
Aftab Ahmed Soomro ◽  
Pirbux Magsi ◽  
Hamid Ali Sangi ◽  
Haresh Chand

Background: The presence of a mass in the nasal cavity and paranasal sinusesmay seem to be simple problem, but it is very difficult to differentiate clinically from potentiallymalignant tumors. Objective: To evaluate the clinical presentation and histopathologicalfeatures of the non malignant lesions of nasal cavity and paranasal sinuses. Study Design:Prospective descriptive study. Place and duration of study: Study was carried out indepartments of Paediatrics and ENT at Ghulam Muhammad Mahar Medical College HospitalSukkur from Jan 2009 to Dec 2012. Patients and Methods: The study included all cases of nonmalignantmasses of nasal cavity and paranasal sinuses, those attended the Paediatric & ENTdepartment and underwent the surgical intervention. One hundred twenty non-malignant caseswere enrolled for this study. A separate pro-forma was filled to record the cases biodata, history,clinical examination, investigations and histopathological diagnosis. All histopathologicallyproven malignant masses were excluded from the study. Results: Out of 120 cases 78 (65%)were males and 42 (35%) were females, with M:F ratio of 1.8:1. The age of presentation rangedfrom 8 years to 70 years and mean age was 26.3years. Sinonasal masses were found to bebilateral in 20 cases (16.67%), right sided in 65 (54.17%) and left sided in 35 (29.16%) cases. Themain presenting symptoms were nasal blockage 110 (91.66%), nasal discharge 102 (85%),sneezing 60 (50%), hypoinsomnia 36 (30%), epistaxis 24 (20%), headache 20 (18.33%) andmouth breathing 18 (15%) cases. Polyp was the most common lesion in 86 (71.66%) casesobserved in this study. The common histopathological diagnosis was simple inflammatory nasalpolyp in 48 (40%), allergic nasal polyps 30 (25%) and fibroepithelial polyp in 8 (6.7%), invertedpapilloma in 12 (10%), angiofibroma 6 (5%), capillary hemangioma 4 (3.34%) andrhinosporidiosis 4 (3.34%) cases. Conclusions: Sinonasal masses have various differentialdiagnoses and are still thought to be simple problem in our society. There is a need for earlyrecognition and referral to ENT surgeon and need histopathological examination of every massto confirm the diagnosis.


2021 ◽  
Vol 8 (33) ◽  
pp. 3054-3059
Author(s):  
Rajendra Prasad Jagannadham ◽  
Lakshmi Latchupatula ◽  
Sravani Ponnada ◽  
Neelima Lalam ◽  
Raghunadhababu Gudipudi ◽  
...  

BACKGROUND A variety of non - neoplastic and neoplastic conditions involve the nasal cavity, paranasal sinuses and nasopharynx and these are very common lesions encountered in clinical practice. Histopathological examination of these lesions is the gold standard for diagnosis because management and prognosis vary among different lesions. The aim of the present study was to evaluate the histopathological study of the lesions of the nasal cavity, paranasal sinuses and nasopharynx in relation to their incidence, age, gender and site wise distribution and to compare the results with the available data. METHODS A study of 88 cases was conducted for a period of 2 years from August 2017 to July 2019. After fixation, Processing and Haematoxylin and Eosin staining and special stains histopathological diagnosis was made. RESULTS Among 88 total cases, 58 were males and 30 were females. A male predominance was observed with a male to female ratio of 1.93 : 1. They were more common in third, fourth and fifth decade of life. Malignant nasal lesions were seen after fourth decade of life. Nasal lesions were more common in nasal cavity (67.05 %), followed by paranasal sinuses (18.18 %) and nasopharynx (14.75). Out of 88 total cases, 39 (44.32 %) were non - neoplastic, 30 (34.09 %) were benign and 19 (21.59 %) were malignant nasal lesions. CONCLUSIONS Sinonasal lesions and nasopharyngeal lesions can have various differential diagnoses. A complete clinical, radiological and histopathological correlation helps to categorize these sinonasal lesions into various non - neoplastic and neoplastic types. But histopathological examination remains the mainstay of definitive diagnosis. KEYWORDS Nasal Cavity, Paranasal Sinuses, Nasopharynx, Benign Tumours, Malignant Tumours, Histopathological Examination


Author(s):  
Dinesh Pal Yadav ◽  
Ramgopal Yadav ◽  
Indra Bhati

Background: Hysterectomy is the most common gynecological surgery done in the females worldwide as it provides definitive cure to a wide range of gynecological diseases, both benign and malignant. The indications to perform this major surgery should always be justified and the pathology should be proved histopathologically. Histopathological analysis and review is mandatory to evaluate the appropriateness of the hysterectomy.Methods: A retrospective, longitudinal study was conducted in the Department of Obstetrics and Gynecology, UMAID Hospital, Dr. S.N. M.C. Jodhpur (Raj.) during October 2014 to March 2015.Total 105 cases were studied during this period. The study included all women undergoing planned abdominal hysterectomy. Data was recorded on proformas, including demographic characteristics and clinical features. Hysterectomy specimens were saved in 10% formalin and sent to the Department of Pathology. Histopathology reports were analyzed and compared with the indications of surgery to draw various informative conclusions.Results: Of 105 cases, 55(52.38%) were in the age group of 41 – 50, which comprised the commonest age group undergoing the surgery. Maximum women (95%) those underwent hysterectomy were multiparous. Most common preoperatively clinical diagnosis was leiomyoma uterus which was diagnosed clinically and sonographically in 51(48.57%) cases. On Histopathological examination, the commonest pathology, similar to clinical impression, was found to be Leiomyoma at 50.48% (n = 53). Adenomyosis (21.90%) was detected as Second most common pathology. Histopathological confirmation of pre-operative diagnosis was 89% for malignancy, 96% for fibroids, 100% for adenomyosis, 100% for pelvic inflammatory disease.Conclusions: There was a high correlation when the clinical diagnosis was a fibroid, adenomyosis and ovarian mass. Every hysterectomy specimen should be subjected to histopathological examination because it is mandatory for conforming diagnosis and ensuring optimal management, in particular of malignant disease.


2014 ◽  
Vol 7 (2) ◽  
pp. 76-79
Author(s):  
Vishal Prasad ◽  
Chandrakala Srinivas ◽  
Sheetal Krishnappa ◽  
Suresh T Narayan Rao ◽  
Harshitha T Rajanna

ABSTRACT Objective To highlight an interesting and a rare case of two rhinoliths in a single nasal cavity of an elderly male patient, mimicking fungal sinusitis or malignancy. To emphasize that rhinolith has to be considered in the differential diagnosis of unilateral nasal mass even in the elderly. Case report A 55-year-old man presented with a right-sided nasal obstruction, foul-smelling nasal discharge and a mass in the right nasal cavity of 6 months duration. Endoscopic examination revealed a gritty, blackish brown mass filling the entire right nasal cavity. A clinical differential diagnosis of malignancy or fungal sinusitis was made. CT scan of paranasal sinus was suggestive of fungal sinusitis following which patient was posted for biopsy. Intraoperatively, patient was found to have two separate masses in the right nasal cavity which were removed. We found a septal perforation adjoining the area where the rhinolith was impacted, with septum pushed laterally and adherent to middle turbinate. However, there were no features suggestive of malignancy. Histopathological examination also ruled out malignancy and confirmed a vegetable foreign body with calcification around an acellular material. Conclusion Rhinolith, though rare should be considered in the differential diagnosis of unilateral nasal mass in the elderly. How to cite this article Prasad V, Srinivas C, Krishnappa S, Rao STN, Rajanna HT. Two Rhinoliths in a single nasal Cavity in an Elderly Patient Mimicking fungal sinusitis. Clin Rhinol An Int J 2014;7(2):76-79.


2018 ◽  
Vol 66 (3) ◽  
pp. 350-364 ◽  
Author(s):  
Éva Gyuris ◽  
Csaba Nemes ◽  
Tibor Magyar

Anatipestifer disease is a contagious disease caused by Riemerella anatipestifer, affecting primarily ducks, geese and turkeys, and characterised by listlessness, diarrhoea, sneezing, nasal discharge, and nervous signs. Sporadically, it occurs in a wide range of other domesticated and wild birds as well. The incidence and characteristics of the disease seen in the three main host species are summarised based on birds submitted for routine laboratory investigation in Hungary over the period 2010–2014. The infection was diagnosed in a higher percentage in geese (9.9%) and ducks (7.5%). It occurred in 5-day-old to 17-week-old geese and 3- to 6.5-week-old ducks, respectively. The pathological lesions were comparable in these two species: enlarged spleen, serofibrinous pericarditis, perihepatitis, airsacculitis, catarrhal enteritis, subcutaneous oedema and hyperaemia over the cranium, mucopurulent exudate in the nasal cavity and occasionally pneumonia, conjunctivitis, purulent arthritis and caseous salpingitis. In some cases, R. anatipestifer produced only secondary lesions, which complicated other diseases such as circovirus infection, mycotoxicosis, mycoplasmosis, or Derzsy’s disease. In turkeys, the disease occurred rarely (0.5%) and at an older age (12 to 19 weeks). The lesions most frequently seen were purulent osteomyelitis of the cranium and seropurulent meningitis. Purulent osteomyelitis in the cranium caused by R. anatipestifer infection had not been reported in turkeys previously. To various extents, other local lesions such as serofibrinous pericarditis, airsacculitis, arthritis, and in one case septicaemia were also observed. The high incidence of the disease in waterfowl underlines the importance of appropriate treatment and prevention that should be based on accurate diagnosis and antimicrobial susceptibility testing, proper biosecurity and vaccination with regard to the serotype(s) present on the farm.


2018 ◽  
Vol 17 (1) ◽  
pp. 88-92
Author(s):  
Pal Subrata ◽  
Chakrabarti Srabani ◽  
Sinha Anuradha ◽  
Phukan Jyoti Prakash ◽  
Bose Kingshuk ◽  
...  

Introduction: Hysterectomy is the most commonly performed gynaecological surgery in India as well as in abroad. It is frequently done in myometrial and endometrial pathologies and rarely for other causes. Hysterectomy is definitive management for diseases like fibroid, adenomyosis, dysfunctional bleeding, prolapsed uterus and malignant lesions of uterus and adenexa. We aimed our study to observe incidence of different pathologies of uterus and other reproductive organs in hysterectomy specimens and retrospective correlation between clinical diagnosis and histopathological finding of hysterectomy cases.Materials and Methods: Retrospective data were collected from our routine histopathological laboratory. Detailed history, clinical examination and operative findings and provisional diagnosis of all 950 hysterectomy cases were recorded during study period of 2 years. Histopathological diagnosis was correlated with clinical and preoperative diagnosis.Observations: Abdominal hysterectomy (734 cases, 77.26%) was the most common route of approach during surgery. Common pre-operative diagnoses were fibroid uterus (32%), dysfunctional uterine bleeding (28.95%), uterine prolapsed (22.74%). Other causes included uterine polyps (1.6%), complications of pregnancy (2.74%), ovarian tumours (8.42%), cervical carcinomas (2.97%) etc. Common pathologies on histology were leiomyoma (32%), adenomyosis (20.32%), atrophic endometrium (17.26%) and endometrial pathology (8.95%).Discussion: Our study has been correlated with other studies of India and other south Asian countries. Most common indication of hysterectomy in our study is dysfunctional uterine bleeding (32%) but Gupta et al and Jha R et al found utero-vaginal prolapse as most common indication. Leiomyoma was the most common histology diagnosed in the present series. Clinical diagnosis was possible in 67.57% cases in our study similar to Khan et al (70.51%).Conclusions: Histopathological examination of hysterectomy specimens helps to detect the exact causes and underlined pathology.Bangladesh Journal of Medical Science Vol.17(1) 2018 p.88-92


2019 ◽  
Vol 6 (8) ◽  
pp. 2856
Author(s):  
Roopali Jandial ◽  
Mehnaz Choudhary ◽  
Kuldeep Singh

Background: Hysterectomy is the most commonly performed gynaecological surgery as the female reproductive system has been affected by various non-neoplastic and neoplastic conditions during the life time of a woman.Methods: This retrospective study was conducted on 160 hysterectomy specimens reported to Department of Pathology. They were compared in terms of age of the patients and pathology of hysterectomy specimens. The histopathological findings of hysterectomy specimens was noted and these findings were then correlated with clinical diagnosis. The aim of the study was to evaluate the wide range of pathological lesions, commonest pathology involved and correlation of the preoperative clinical diagnosis with the histopathological diagnosis in the hysterectomy specimens.Results: The most common type of hysterectomy was total abdominal hysterectomy with bilateral salpingo-ophorectomy with 102 cases (63.7%). Peak incidence at 5th decade of life in 92 cases (57.5%) was noted. The most common clinical indication was fibroid uterus in 81 cases (50.6%). Proliferative phase of endometrium was the commonest finding in 87 cases (54.3%). In case of myometrium, 95 leiomyomas were noted. On histomorphological study of cervical lesions, chronic cervicitis was commonest finding in 75 (46.8%) cases.Conclusions: Few double pathologies can be missed clinically so clinico-pathological correlation in all cases of hysterectomy has been proved to be important to improve the clinical outcome and post-operative management.


2013 ◽  
Vol 25 (2) ◽  
Author(s):  
Galih Fata Anadza ◽  
Endang Syamsudin ◽  
Abel Tasman Yuza

Introduction: The diagnosis of a pathological disorder can be made in various stages, namely history taking, clinical examination and supporting examination. Clinical diagnosis is a diagnosis obtained from anamnesis and the results of clinical examination. Histopathological diagnosis is a diagnosis obtained from a microscopic examination of tissue. Clinical diagnosis and histopathological examination results may differ. The aim of the study was to obtain the accuracy value of the dentist’s clinical diagnosis by calculating the number of differences between the clinical diagnosis and the results of the histopathological examination of patients who were biopsied in the Department of Oral Surgery of General Hospital Dr. Hasan Sadikin Bandung. Methods: A retrospective descriptive study of cases of pathological abnormalities biopsied in the Department of Oral and Maxillofacial Surgery of General Hospital Dr Hasan Sadikin Bandung. The total number of study samples was 109 medical records of patients with biopsy. Results: The accuracy value of the clinical diagnosis of dentists was 76%, where the difference between the clinical diagnosis and the histopathological examination was 24%. The most common type of disorder with the greatest difference in diagnosis is ameloblastoma followed by papilloma and mucocele. Conclusion: The accuracy value of the clinical diagnosis of dentists in oral lesions performed biopsy is 76%.


Author(s):  
Vikrant Mittal ◽  
Manish Munjal ◽  
Rohit Verma ◽  
Parth Chopra ◽  
Hemant Chopra

<p class="abstract"><strong>Background:</strong> Vocal cords are the most common site of laryngeal pathologies. Hoarseness is the sentinel symptom for lesions affecting the glottis. The aim of this study was to categorize various types of lesions affecting the glottis in patients undergoing microlaryngeal surgery. Patients’ demographic profile, gender, occupational factors were studied. Clinical, microlaryngeal and histopathological correlation of the lesions was done.</p><p class="abstract"><strong>Methods:</strong> 50 patients with glottic pathologies undergoing microlaryngeal surgery were included. Patients underwent detailed examination including indirect laryngoscopy, flexible fibreoptic laryngoscopy, followed by microscopic laryngeal examination under general anaesthesia. The lesions were excised using standard microlaryngeal instruments and the specimens were subjected to histopathological examination. The data was analysed.  </p><p class="abstract"><strong>Results:</strong> There was male preponderance (male: female ratio of 1.27:1). Housewives formed the largest group (28%). Commonest pathologies were vocal nodules (34%), vocal polyps (22%) and carcinoma (22%). Microlaryngoscopy was found to be the best means of visualizing the lesions and reaching a clinical diagnosis. In 10 (20%) patients, the final histopathological diagnosis was different from clinical diagnosis.</p><p class="abstract"><strong>Conclusions:</strong> In this study, vocal nodules were the commonest lesions to affect the glottis. Microlaryngoscopy proved to be the best method for examination. Also, there was discrepancy in the clinical and histopathological diagnosis in 20% cases.</p>


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