Spectrum of histopathological lesions of nose and paranasal sinuses: A 5-year study

Abstract

Aims and Objectives: To study the spectrum of lesions of nose and paranasal sinuses over a period of 5 years in a tertiary care hospital. To find the incidence and age and sex distribution along with their clinical presentation and various histopathological patterns. Materials and Methods: The study included biopsies and resection specimens. The clinical details such as age and sex of the patient, clinical presentation, and radiological findings were retrieved from the records. The tissue specimens were processed after fixing in 10% formalin and stained with hematoxylin and eosin stains. Various special stains were performed as per the need such as Gomori methenamine silver stain and periodic acid–Schiff for fungus. The neoplastic lesions were classified as per the World Health Organization 2017 classification. Results: The incidence of nose and paranasal sinus lesions was 0.71% (310 cases). Nonneoplastic cases (156) constituted 50.32%, whereas neoplastic lesions (154) constituted 49.67%. Benign neoplasms (126) were 40.64% and malignant neoplasms (28) formed 9.03% of total neoplasms. A wide age ranging between the 1st and 9th decades was observed. Male predominance in neoplastic as well as nonneoplastic lesions was noted. Nasal obstruction (90.96%) was the most common symptom seen. Radiology was available in 30 cases and accurate diagnoses were made in 28 cases (93.33%). Among nonneoplastic lesions, inflammatory cases (128) formed the largest group (82.05%). Nasopharyngeal angiofibroma (NPA) was the dominant benign neoplasm (67.46%) exclusively seen in males of the second decade (76.47%). Among malignant lesions (9.03%), squamous cell carcinoma was the most common (28.57%) malignancy. Lesions with round cell morphology could not be typified on histopathology; hence, immunohistochemistry (IHC) was done for the exact diagnosis. Conclusion: This study elaborates wide spectrum of lesions encountered in nose and paranasal sinuses with their relative frequencies in the population. Nonneoplastic lesions are more common than neoplastic lesions. Histopathological examination is essential for the diagnosis as clinical and radiological features may be overlapping. Round cell tumors could not be typified on the basis of histopathology; hence, use of ancillary techniques such as IHC plays a vital role in diagnosis.