Pathologic Evaluation of Routine Nasopharynx Punch Biopsy in the Adult Population: Is It Really Necessary?

Abstract

Objectives To retrospectively evaluate the patients who underwent nasopharyngeal biopsy with imaging and biopsy results, who have or don’t have symptoms for nasopharyngeal pathology and to determine the ratio of the nasopharyngeal cancer cases and other pathologic conditions.Methods In this retrospective study, 983 patients who underwent endoscopic nasopharyngeal biopsy for symptomatic nasopharyngeal lesions were included. All pathological results, benign or malign was recorded and classified due to the patients’ presenting symptoms such as symptomatic for nasopharyngeal pathology or asymptomatic. Computed tomography (CT) or magnetic resonance imaging (MRI) reports were also recorded separately as group A for malignancy or group B for not malignancy.Results Forty-five (4.6%) of 983 biopsies were malignant. In this group, there is no statistically significant difference between symptomatic and asymptomatic group. For malignant pathologies, the sensitivity of MRI was found 88.2% and CT was 61.5%.Conclusion For early diagnosis of nasopharyngeal cancer, all patients admitted to Ear, Nose and Throat (ENT) referral clinics should be examined endoscopically irrespective of their complaints and suspicious cases should be investigated by imaging especially by MRI. If MRI report clearly indicates Thornwaldt cyst or reactive lymphoid hyperplasia and this result is compatible with endoscopic findings, biopsy may not be necessary. Apart from these cases, all suspected lesions should be biopsied.

A Retrospective Analysis of Nasopharyngeal Biopsy Results in Adult Patients

“…The masses in this region are important for adults in terms of malignancy. The symptoms of nasopharyngeal malignancy are not specific, and, additionally, due to its localization, patients generally present in the late period, and this causes delay in treatment [ 6 , 8 ].…”

“…Regarding this subject, in the study of King et al, 95% accuracy rate, 100% sensitive, 93% specificity, and 87% positive predictive value were determined for nasopharyngeal MRII in primary nasopharyngeal cancers. Bercin et al stated that the sensitivity of MRI was 88.2% in nasopharyngeal malignancies [ 4 , 8 ]. In our study, MRI was also found to be the most preferred imaging method.…”

Risk factors for competing non‐cancer mortality after definitive treatment for advanced‐stage head and neck cancer

“…The patients underwent careful physical and endoscopic examinations at every clinic visit, scheduled every 1–3 months during the first year, every 2–4 months during the second year, every 4–6 months during the third, fourth, and fifth years, and annually thereafter (Ahn et al., ; Denaro, Merlano & Russi, ). Any recurrent or new tumors were confirmed by biopsies and specific additional diagnostic tests including CT/MRI and/or 18 F‐FDG PET/CT scanning (Bercin et al., ). Second primary cancer was defined according to the criteria proposed by the National Cancer Institute as follows: if it was of different pathology or in a different location from the index cancer, or developed in the same region after more than 5 years of the index cancer diagnosis (Curtis et al., ).…”

Nasofarinks biyopsi uygulanan hastaların klinikopatolojik verilerinin analizi: tek merkezli retrospektif çalışma.

“…Amacımız, 9 yıllık bir süreçte şüpheli nazofaringeal lezyonları tanımlamak için alınan biyopsi sonuçlarını klinik ve patolojik verilerle karşılaştırmak. (6,11). Literatürle uyumlu olarak çalışmamızda izlenen tornwaldt kisti benign lezyonların yaklaşık %1'ini (5/464) oluşturmaktaydı.…”

“…Erken dönemde tanı konduğu takdirde küratif olabilen bu tümörlerin yarısından fazlası ileri evrede tanı almaktadır (12). Yapılan önceki çalışmalarda nazofarinkste izlenen en sık malign tümörler sırasıyla nazofarinks ve hematolenfoid malignite olduğu bildirilmiştir (4,6,11,13,14). Literatürle uyumlu olarak malign olgularımızın %77.4'ü nazofaringeal karsinom ve %21.1'i ise hematolenfoid maligniteden oluşmaktaydı.…”