Histologic Types and Associated Findings of Nasal Polyp

Park, Seong Kook; Heo, Kyung Wook; Kim, Young Ju

Abstract

BACKGROUND AND OBJECTIVES: Nasal polyp is a chronic inflammatory disease of the nasal mucosa. This study is aimed to investigate the proportion of different histologic types of nasal polyp and its relationships with the history of allergic diseases, hematologic items, and laterality of the nasal polyp. MATERIALS AND METHOD: The authors examined the tissue slides of nasal polyps from 496 patients who underwent nasal polypectomy for 5 years and classified nasal polyps according to the inflammatory type, allergic type, inflammatory type with hyperplasia of the seromucinous gland and/or stromal atypia, or allergic type with hyperplasia of the seromucinous gland and/or stromal atypia. And the history of allergic rhinitis or bronchial asthma, the serum level of immunoglobulin E (IgE) and eosinophil, and the laterality of nasal polyp were noted from the medical records.
RESULTS
The proportion of the inflammatory and allergic types in the nasal polyp patients was 74.8% and 25.2%. The inflammatory type was accompanied by hyperplasia of the seromucinous gland and stromal atypia in 0.4% and 5.39% each. The allergic type was accompanied by hyperplasia of the seromucinous gland and stromal atypia in 14.4% and 0.8% each. One case (0.8%) of allergic type was accompanied by both changes. 4.64% of patients had past histories of allergic rhinitis which was correlated with the allergic type. 3.83% of patients had past histories of bronchial asthma which also correlated with the allergic type. In the inflammatory type, 19.29% and 37.36% showed eosinophilia and an elevated lelvel of IgE in the peripheral blood. In the allergic type, 40.00% and 48.72% showed eosinophilia and an elevated level of IgE in the peripheral blood, and the peripheral eosinophilia was related with the allergic type. Unilateral polyp was more frequent in the inflammatory type (22.90%) than in the allergic type (17.60%).
CONCLUSION
The present histologic typing of nasal polyp for Koreans showed that the inflammatory type was dominant, and the allergic type was related with past histories of allergic diseases and peripheral blood eosinophilia. There needs to be more studies about the effects of the allergic type on the prognosis of nasal polyp.