Nasal polyp epithelial atypia and exposure to nickel and copper.

BACKGROUND: Possible factors for cell atypia in nasal mucosa include noxious chemicals: ammonia, formaldehyde and heavy metals. AIMS: Case presentation of a nasal polyp with epithelial dysplasia in a worker exposed to nickel and copper salt dust. CASE REPORT: A 27-year-old man complained of impaired nasal breathing and mild right-sided epistaxis. He was exposed to copper and nickel salt dust for 6 years. Clinical examination showed a polypoid lesion arising from the right middle turbinate. Histopathological examination of the excised lesion showed high-grade epithelial dysplasia. Duration of exposure and concentration of heavy metals in serum suggest the biological plausibility of exposure to these factors and development of epithelial dysplasia in the nasal mucosa. CONCLUSIONS: Epithelial dysplasia may occasionally be noted in inflammatory nasal polyps, especially in workers exposed to heavy metals.

Middle turbinate chondro-osseous respiratory epithelial adenomatoid hamartoma.

OBJECTIVE: Chondroosseous respiratory epithelial adenomatoid hamaroma (COREAH) is an extremely rare, developmental malformation. COREAH is characterized by a spectrum of chondro-osseous metaplasia that arise from the mesenchymal stroma, and it includes dilated submucosal glands lined with respiratory epithelium. This case report aimed to describe a COREAH that originated in the nasal cavity. CASE REPORT: A 68-year-old woman presented with unilateral nasal obstruction. Endonasal and radiological findings suggested a diagnosis of an unilateral inflammatory polyp. However, after excision of the mass with endoscopic guidance, a histological examination supported a final diagnosis of a nasal COREAH. CONCLUSION: To our knowledge, this was the first description of a COREAH that originated from the middle turbinate and presented as a choanal polyp. The role of the pathologist is essential for a correct diagnosis.

Correlation between cytokine levels in nasal fluid and eosinophil counts in nasal polyp tissue in asthmatic and non-asthmatic patients

Background/ Aims: Concentrations of mediators in nasal secretions could reflect the inflammatory status of the nasal mucosa and evolution of sinus disease. So, the aim of our study was to evaluate local immune reaction by measuring crucial Th1, Th2 and inflammatory cytokines innasal fluid samples of patients with nasal polyps (NP), and to correlate them to clinical, radiological findings and to the degree of eosinophil infiltration of polyp tissue. Therefore, in our study we compared the cytokine levels in nasal fluid of asthmatic and non-asthmatic patients with nasal polyposis, the eosinophil counts in NP tissues of these patients, and we correlated cytokine levels with eosinophil counts in NP tissue specimens. Material and methods: Thirty patients with nasal polyposis (NP) (15 asthmatic and 15 non asthmatic) were included in this prospective study. Nasal secretion samples were collected from nasal cavities of all subjects. The levels of 11 cytokines (TNF- , TNF- , IL-1 , IL-2, IL-4,IL-5, IL-6, IL-8, IL-10, IL-12, and IFN- ) were measured using commercial flow cytometric kit. Eosinophils were counted in haematoxylin-and-eosin-stained NP sections. Results: The concentrations of Th2 cytokines IL-5, IL-6, IL-10, and Th1 cytokine IFN- were significantly higher in patients with NP and asthma compared with non-asthmatic subjects. A positive correlation was found between IL-6 and TNF- levels in nasal fluid and eosinophil counts in polyp tissue in non-asthmatic subjects. In asthmatic NP patients, we found positive correlation between level of IL-6 and eosinophil counts and negative correlation between IFN- level and number of eosinophils in NP tissue specimens. Conclusion: Our results showed that these patients with similar clinical findings had significantly different mediator profiles in their nasal secretions, implying clear differences in pathogenesis of their NP (AU)

Correlation between cytokine levels in nasal fluid and eosinophil counts in nasal polyp tissue in asthmatic and non-asthmatic patients.

BACKGROUND/AIMS: Concentrations of mediators in nasal secretions could reflect the inflammatory status of the nasal mucosa and evolution of sinus disease. So, the aim of our study was to evaluate local immune reaction by measuring crucial Th1, Th2 and inflammatory cytokines in nasal fluid samples of patients with nasal polyps (NP), and to correlate them to clinical, radiological findings and to the degree of eosinophil infiltration of polyp tissue. Therefore, in our study we compared the cytokine levels in nasal fluid of asthmatic and non-asthmatic patients with nasal polyposis, the eosinophil counts in NP tissues of these patients, and we correlated cytokine levels with eosinophil counts in NP tissue specimens. MATERIAL AND METHODS: Thirty patients with nasal polyposis (NP) (15 asthmatic and 15 non-asthmatic) were included in this prospective study. Nasal secretion samples were collected from nasal cavities of all subjects. The levels of 11 cytokines (TNF-α, TNF-ß, IL-1ß, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, and IFN-γ) were measured using commercial flow cytometric kit. Eosinophils were counted in haematoxylin-and-eosin-stained NP sections. RESULTS: The concentrations of Th2 cytokines IL-5, IL-6, IL-10, and Th1 cytokine IFN-γ were significantly higher in patients with NP and asthma compared with non-asthmatic subjects. A positive correlation was found between IL-6 and TNF-α levels in nasal fluid and eosinophil counts in polyp tissue in non-asthmatic subjects. In asthmatic NP patients, we found positive correlation between level of IL-6 and eosinophil counts and negative correlation between IFN-γ level and number of eosinophils in NP tissue specimens. CONCLUSION: Our results showed that these patients with similar clinical findings had significantly different mediator profiles in their nasal secretions, implying clear differences in pathogenesis of their NP.