Aspectos histológicos do pólipo rinossinusal / Histological aspects of rhinosinusal polyps

Estudo de coorte contemporânea com corte transversal. As diferenças histológicas dos pólipos nasais e a sua possível implicação clínica são escassas em literatura, apesar de sua importância para um diagnóstico preciso. Os trabalhos existentes classificam amostras de pólipos sem a preocupação quanto à influência de tratamentos prévios, o que influenciaria o resultado obtido. OBJETIVO: Estudar morfologicamente, através da microscopia ótica, as alterações estruturais do pólipo nasal na ausência de qualquer tratamento prévio e classificá-lo, histologicamente, correlacionando com os estudos de literatura. MATERIAL E MÉTODOS: Foram estudados 89 pacientes com polipose rinossinusal sem tratamento prévio. As amostras dos pólipos foram colhidas por biópsia ambulatorial e analisadas através de microscopia ótica após coloração com hematoxilina e eosina. RESULTADOS: As amostras foram classificadas da seguinte forma: pólipo Edematoso ou Eosinofílico: 65 casos (73 por cento); pólipo Fibroinflamatório: 16 casos (18 por cento); pólipo com Hiperplasia de Glândulas Seromucinosas: 06 casos (6,7 por cento) e pólipo com Atipia de Estroma: 2 casos (2,3 por cento). DISCUSSÃO: O padrão eosinofílico predominou nos pacientes com polipose rinossinusal na população estudada. Este padrão assemelha-se com os principais estudos que, no entanto não mencionam sobre tratamentos prévios. CONCLUSÃO: Após análise das características histológicas dos pólipos, observou-se que pólipos não tratados apresentam um padrão predominantemente eosinofílico.

Contemporary cohort cross-sectional study. Introduction: Despite its importance for an accurate diagnosis, histology differences among nasal polyps and its clinical implications are rarely reported in the literature. The existing papers classify polyp samples without concern for prior treatments, which could influence the results attained. AIMS: carry out a morphological study, through light microscopy, of nasal polyps' structural alterations in the absence of any type of prior treatment and histologically classify it in relation to studies published in the literature. MATERIALS AND METHODS: We studied 89 patients with nasosinusal polyps without prior treatment. Polyp samples were collected by outpatient biopsy and analyzed through light microscopy after dyeing with hematoxylin-eosin. RESULTS: Samples were classified in the following way: Edematous or eosinophilic polyp 65 cases (73 percent); fibro-inflammatory polyp: 16 cases (18 percent); Polyp with Sero-mucinose gland hyperplasia: 06 cases (6.7 percent) and polyp with stroma atypia: 2 cases (2.3 percent). DISCUSSION: eosinophilic pattern prevailed in the patients with nasosinusal polyps of the population studied. This pattern is similar to the ones found in the major studies, which, however, do not mention prior treatment. CONCLUSION: after analyzing the polyps' histological characteristics, we noticed that the untreated polyps present a predominantly eosinophilic pattern.

Allergic rhinitis with and without nasal polypi [Electron microscopic study]

Allergic nasal polyposis is an agonizing problem in the practice of otorhinolaryngology. The exact etiology and pathogenesis are still a matter of controversy. The present work aimed to clarify the sequence of events in the pathogenesis of nasal allergy and to throw a light on the initiating factors that predispose to polypoidal formation. Nasal biopsies were taken from selected twenty male patients with allergic rhinitis [10 patients without polypi and 10 with polypi]. The associated polypus tissue was studied. Biopsies were taken also from five volunteers used as a control. Electron microscopic study of the allergic nasal mucosa showed thickening and metaplasia of the lining epithelium with thickening of their basement membrane. The lamina propria manifested cellular infiltration especially those of fibroblast, lymphocytes, plasma cells, macrophages and mast cells which depicted a degree of degranulation more in cases with polyposis. The glandular structures showed hyperactivity of the serous element with loss of their microvilli and cilia. Zymogen granules appeared more numerous and of more electron density. There was increased vasculature with hypertrophy and gaping of the endothelial lining cells and thickening of the basal lamina of blood capillaries. Polypus tissue showed a structure similar to that of allergic nasal mucosa. Their epithelial cells were widely separated and the stroma was edematous. The vasculature and glandular elements were greatly reduced. The ultrastructural changes in allergic rhinitis with elements were greatly reduced. The ultrastructural changes in allergic rhinitis with and without polyposis were more or less the same. The changes were more marked in cases with polyposis. This might be due to difference in the degree of tissue reaction to allergen which may be due to the variability in the initial site that provoke it