POLYPOID NASAL MASSES;

SURGICAL PATHOLOGY

Abstract

Objectives: The purpose of this study is firstly to signify the occurrence of
unusual nasal polypoid masses by analyzing their histopathological spectrum and to be on the
lookout for them. Secondly to highlight the fact that nasal polypoid masses should not be taken
lightly as they may be representing an underlying grave pathological process meriting urgent
medical advice. Study Design: Retrospective/observational study. Setting: Charsada Teaching
Hospital affiliated with Jinnah Medical College Peshawar. Period: March 2010 to March 2015.
Methods: In this study, all the surgical pathology cases with clinical diagnosis of nasal polyps
with no suspicion for malignancy were retrieved from archives of Charsada Teaching Hospital
affiliated with Jinnah Medical College Peshawar. The slides and diagnoses of all the retrieved
cases were reviewed. The number of cases for each diagnostic category were recorded and
analyzed according to the non-neoplastic, neoplastic and their subcategories. Results: The
review of cases from March 2010- March 2015 showed that most of the polypoid masses were
non-neoplastic, while only few were neoplastic. Of all the non-neoplastic masses, inflammatory/
allergic polyps were much more common followed bypolyps with fungal infections and
eosinophilic angiocentric fibrosis. Amongst the neoplastic masses, benign tumors were more
common than the malignant. The benign masses comprised of hemangioma, angiofibroma,
inverted papilloma and schwannoma. The malignant nasal masses constituted one case each
of polypoid extraskeletal Ewings sacoma, plasmacytoma, non-Hodgkin lymphoma and renal
cell carcinoma. Conclusions: Awareness about the occurrence of the usual and unusual
entities in the nasal cavities needs to be increased. Important diagnostic categories requiring
urgent management include polyps with invasive fungal infection, inverted papilloma and all
malignant cases. Therefore, all unilateral nasal cavity masses with frequent epistaxis, pain or
bone erosions should be submitted for histopathological examination.