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Structured histopathology profiling of chronic rhinosinusitis in routine practice
Kornkiat Snidvongs1, Matthew Lam, Raymond Sacks
1Australian School of Advanced Medicine, Macquarie University, Sydney, Australia. drkornkiat@yahoo.com
International Forum of Allergy & Rhinology
|March 16, 2012
Summary
Tissue eosinophilia in chronic rhinosinusitis (CRS) can occur without traditional markers like asthma. Serum eosinophilia may indicate tissue eosinophilia but has limited predictive value, suggesting a need for better diagnostic methods.
Area of Science:
- Otorhinolaryngology
- Immunology
- Pathology
Background:
- Tissue eosinophilia is a key feature of eosinophilic chronic rhinosinusitis (ECRS), often linked to asthma, nasal polyps, and allergies.
- However, ECRS can manifest without these classic associations, necessitating alternative diagnostic markers.
- This study investigated associations between histopathology, serology, and clinical features in CRS patients to identify reliable indicators of tissue eosinophilia.
Purpose of the Study:
- To determine the associations between histopathology, serology, and clinical characteristics in patients with chronic rhinosinusitis (CRS).
- To evaluate the reliability of traditional ECRS markers and explore potential surrogate markers for tissue eosinophilia.
Main Methods:
- A cross-sectional study involving 51 CRS patients undergoing surgery.
- Comparison of tissue eosinophilia and other pathological findings with traditional ECRS features, symptoms, and endoscopic/radiologic scores.
Main Results:
- High tissue eosinophilia (>10 HPF) was prevalent in polyps (84%) but also present in non-polyp cases (19%).
- Asthma was not significantly associated with high tissue eosinophilia (p=0.60).
- Serum eosinophilia (>0.30 × 10(9)/L or 4.4% leukocytes) showed moderate predictive value (AUC=0.001, specificity 87%) for tissue eosinophilia, while serum IgE was nonpredictive (p=0.08).
Conclusions:
- Traditional ECRS phenotype markers are not always reliable indicators of tissue eosinophilia.
- Serum eosinophilia can serve as a potential surrogate marker but has limited clinical utility.
- Structured histopathology reporting is recommended for accurate ECRS diagnosis and identification of prognostic markers in CRS.
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