On histopathological examination, nasal polyps and nasal mucosa in allergic rhinitis show different forms of pseudostratifi ed respiratory epithelium, whereas the dominant characteristic of lamina propria is an eosinophilic infi ltration. The aim of this study was to compare interleukin (IL)-5 and eosinophilic cationic protein (ECP) levels in the nasal fl uid of 42 patients: 12 with allergic rhinitis and nasal septal deviation, 17 non-atopic patients with nasal polyposis, and 13 atopic nasal polyp patients were enrolled in this crosssectional study. Nasal secretion samples were collected a few days before surgery. The levels of IL-5 were measured using fl ow cytometry and the ECP using a commercial ELISA kit. In addition, we counted eosinophils in hematoxylin-and-eosin-stained sections of all nasal polyp and all nasal mucosa samples taken from the inferior nasal turbinates during septoplasty. A signifi cantly higher concentration of IL-5 was found in the nasal fl uid of atopic patients with nasal polyposis than in non-atopic nasal polyp patients (p=0.025) and patients with allergic rhinitis (p=0.05). ECP was higher in atopic nasal polyp patients than in patients with allergic rhinitis (p<0.0001) and than in non-atopic nasal polyp patients (p<0.0001). Polyp eosinophils were higher in atopic' than in non-atopic patients (p<0.0001) and higher than in the mucosa of patients with allergic rhinitis (p<0.0001). These however had signifi cantly more mucosal eosinophils than was found in the polyps of non-atopic patients' (p=0.025). ECP levels in nasal fl uid and eosinophil counts in tissue specimens correlated well in all three groups of patients. Our study has shown that atopic nasal polyp patients have a higher level of eosinophilic infl ammation than non-atopic patients with nasal polyps and patients with allergic rhinitis. Arh Hig Rada Tokiskol 2011;62:341-348 Allergic rhinitis is the most common atopic disease in the human population as it affects one in four people worldwide (1, 2). Its prevalence in the European countries ranges between 15 % and 25 %, with a tendency to rise by about 3.5 % with every decade (3). It is a type I allergic reaction mediated by mast cellbound immunoglobulin E (IgE) with a typical helper T-cell type 2 (Th2) profi le (3). KEY WORDS: eosinophilic cationic protein, eosinophils, epithelium, interleukin-5, nasal fl uid Perić A, et al. INFLAMMATORY MEDIATORS IN ALLERGIC RHINITIS AND NASAL POLYPOSISNasal polyposis is characterised by the proliferation of pseudostratifi ed respiratory epithelium, thickening of the basement membrane, oedema, proliferation of fi broblasts, focal fi brosis, and infl ammatory infi ltration of the lamina propria (4). The stromal layer of the polyp tissue includes mixed infl ammatory cells. The predominant histological form of nasal polyposis is the eosinophilic type, with an incidence of about 90 % (5). The non-eosinophilic form of nasal polyps is much less common and the dominant cells in the stroma are lymphocytes and plasmocytes (5). Polyps usually originate ...
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.
Extranasopharyngeal angiofibromas arising from the nasal cavity are extremely rare tumors. Immunohistochemical analysis is very important in all doubtful cases, especially in those with atypical location.
Antrochoanal polyps are benign lesions originating from the mucosa of the maxillary sinus. Nasal obstruction and rhinorrhea are their main symptoms. Their endoscopical and radiological appearance makes them relatively easy to diagnose. These polyps are usually presented unilaterally, although bilateral presentation is also possible. We described two cases of atypically giant antrochoanal polyps: in a 15-year-old child and in a 38-year-old man. In both cases, the diagnosis was done by nasal endoscopy and computed tomography (CT) of the paranasal sinuses and supported by histopathological analysis. In the first patient, the excised polyp had the histological characteristic of an angiomatous antrochoanal polyp. Because of their unusual dimension, the combined transoral and endonasal endoscopic approach was performed for complete polyp excision. We discussed the clinical, histopathological and immunohistochemical characteristics of choanal polyps in comparison to inflammatory nasal polyps, and the applicable surgical techniques for treatment of these polyps.
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