A histopathological study: chronic rhinosinusitis in adolescents versus adults

Abstract

To conduct a histopathology study of adolescents with chronic rhinosinusitis (CRS) to compare the sinus mucosa with adult CRS and to explore their different pathological characteristics and lesion patterns. Twenty cases of adolescents (median age: 14 years; range: 11-16 years) and 16 cases of adult CRS (median age: 36 years; range: 21-56 years) were performed functional endoscopy operation despite conventional medical therapy, histopathology of uncinate process mucosa were analyzed for inflammatory cell and morphologic studies. Archival tissue from adolescents and adults with CRS were stained with HE, AB-PAS (alcian blue-periodic acid-schiff) as well as Van Gieson. Statistical analysis t-test was performed using SPSS. Adolescents CRS sinus mucosa, as compared with adult CRS control, had a higher density of submucosal lymphocytes (t = 2.09, P = 0.04), higher density of submucosal plasma cell (t = 2.46, P = 0.02), lower density of submucosal eosinophils (t = -3.72, P = 0.01), thinner basement membranes and more intact epithelium (t = -2.50, P = 0.02 and t = 5.63, P = 0.00 respectively) and fewer submucosal mucous glands (t = -2.13, P = 0.04). There were significant differences between two groups. Lymphocytes were the predominant inflammatory cell type in the sinus mucosa of adolescents with CRS. But it has less eosinophilic inflammation, more plasma cell infiltration, basement membrane thickening, and mucus gland hyperplasia in characteristic adult CRS. Differences between adolescents and adult CRS suggest differing pathogenic mechanisms or progression in the inflammatory response with a protracted disease.