Correlations Between Clinical and Histological Aspects in Nasal Polyposis

Abstract

The histological study of nasal polyps does not reveal any specific lesions but eosinophilic infiltration nasal mucosae seems to be characteristic of nasal polyposis. The aim of this work is to study possible links between certain histological and clinical aspects in nasal polyposis. Furthermore, we attempt to compare the quantification of tissue eosinophilia according to the number of eosinophils per field with the percentage figure obtained with respect to the total of inflammatory cells. We have studied 40 patients with idiopathic bilateral nasal polyposis, assessing the correlations between various clinical aspects such as their endoscopic and radiological status, association with asthma and intolerance to NSAIDs, against histological aspects of nasal polyps such as the frequency of metaplasia, fibrosis and the degree of eosinophilic infiltration. A group of 12 healthy subjects allowed comparison of our results with healthy nasal mucosa. Tissue eosinophilia correlates statistically with clinical staging and tends to be higher in patients with ASA triad. The quantitative measurement of tissue eosinophilia (number of eosinophils per field) correlates with the percentage figure obtained (with respect to the total number of inflammatory cells in the infiltrate). Eosinophil infiltration of the nasal mucosa is, together with oedema, the most constant histological characteristic of nasal polyposis and seems to be an important factor in the clinical behaviour of sinonasal polyposis. Quantitative measurement of tissue eosinophilia is easier and quicker to perform and equivalent to percentage evaluation.