Structured histopathology and laboratory evidence in nasal polyposis with different pathogenesis

Giuseppe Brescia; Lara Alessandrini; Samuele Frasconi; Giacomo Contro; Anna Chiara Frigo; Gino Marioni

doi:10.1016/j.amjoto.2022.103649

Structured histopathology and laboratory evidence in nasal polyposis with different pathogenesis

Am J Otolaryngol. 2023 Jan-Feb;44(1):103649. doi: 10.1016/j.amjoto.2022.103649. Epub 2022 Oct 5.

Authors

Giuseppe Brescia¹, Lara Alessandrini², Samuele Frasconi¹, Giacomo Contro¹, Anna Chiara Frigo³, Gino Marioni⁴

Affiliations

¹ Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy.
² Department of Medicine-DIMED, University of Padova, Padova, Italy.
³ Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Padova, Italy.
⁴ Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy. Electronic address: gino.marioni@unipd.it.

PMID: 36257231
DOI: 10.1016/j.amjoto.2022.103649

Abstract

Purpose: Non-steroidal anti-inflammatory drugs-exacerbated respiratory disease (NERD), intrinsic asthma, eosinophilic granulomatosis with polyangiitis (EGPA) and odontogenic sinusitis may be associated with nasal polyps. The aim of the study was to compare circulating inflammatory cells and structural histopathology of these groups of nasal polyposis.

Methods: We retrospectively evaluated 71 patients with nasal polyps stratified according to the above-mentioned pathogenesis. All patients underwent preoperative laboratory investigations and primary endoscopic sinus surgery. Surgical specimens were submitted to structured histopathological evaluation.

Results: The median tissue eosinophil count (cells/HPF) was significantly different between the considered groups of nasal polyposis (p=0.0004). The median of NERD sub-cohort was significantly higher than intrinsic asthma (p=0.0030), odontogenic CRS (p=0.0001) and EGPA ones (p=0.0094). Eosinophilic aggregates positive rate was significantly higher in NERD sub-cohort than in odontogenic CRS (p=0.0072), EGPA (p=0.0497) and asthma (p=0.0188) ones. EGPA sub-cohort had a higher neutrophil infiltrate positive rate than NERD (p=0.0105) and intrinsic asthma ones (p=0.0040). Odontogenic CRS sub-cohort had a higher neutrophil infiltrate positive rate than NERD (p=0.0140) and asthma ones (p=0.0096). EGPA sub-cohort had a higher presence of fibrosis than NERD (p=0.0237) and odontogenic CRS sub-cohort (p=0.0107). Odontogenic sub-cohort had a lower sub-epithelial edema positive rate than NERD (p=0.0028) and asthma (p=0.0149) ones.

Conclusions: Structural histopathology may identify nasal polyps histotypes with different morphological patterns. The identified histopathological features can facilitate the recognition of rational therapeutic and follow-up approaches that consider the tissue modifications associated with the response to drugs and surgery.

Keywords: Asthma; EGPA; NERD; Nasal polyps; Odontogenic chronic rhinosinusitis; Structured histopathology.

MeSH terms

Asthma* / complications
Chronic Disease
Churg-Strauss Syndrome* / complications
Granulomatosis with Polyangiitis*
Humans
Nasal Polyps* / complications
Retrospective Studies
Rhinitis* / surgery