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Distinct Histopathologic Features of Complicated Sinusitis.

Hannah J Brown1, Ashwin Ganti2, Paolo Gattuso3

  • 1Rush Medical College, Rush University Medical Center, Chicago, IL, USA.

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|May 3, 2021
PubMed
Summary

Complicated sinusitis (CS) shows distinct histopathology, differing from chronic rhinosinusitis without nasal polyps (CRSsNP) and with nasal polyps (CRSwNP). CS involves aggressive neutrophilic inflammation, not fitting typical polyp or non-polyp profiles.

Keywords:
chronic rhinosinusitiscomplicated sinusitishistopathologyintracranial extensionorbital involvement

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Area of Science:

  • Otolaryngology
  • Pathology
  • Immunology

Background:

  • Complicated sinusitis (CS) with intracranial or orbital extension is life-threatening, necessitating urgent care.
  • Understanding the histologic features of CS is crucial for elucidating its pathophysiology.

Purpose of the Study:

  • To determine the distinct histopathological features of complicated sinusitis (CS).
  • To compare the histopathology of CS with chronic rhinosinusitis without nasal polyps (CRSsNP) and with nasal polyps (CRSwNP).

Main Methods:

  • A structured histopathology report analyzed sinus tissue from 24 CS, 149 CRSsNP, and 191 CRSwNP patients.
  • Thirteen histopathology variables were compared across the three patient groups.

Main Results:

  • CS patients exhibited significantly greater overall inflammation compared to CRSsNP patients (66.7% vs. 41.6%).
  • CS patients had fewer eosinophils and eosinophil aggregates than CRSwNP patients, but enhanced neutrophil infiltration compared to CRSsNP patients.
  • A predominant lymphoplasmacytic inflammatory infiltrate was observed in 91.7% of CS patients, significantly higher than in CRSsNP and CRSwNP patients.

Conclusions:

  • Significant histopathological differences exist between CS, CRSsNP, and CRSwNP.
  • CS presents a unique profile, characterized by aggressive neutrophilic inflammation, distinct from CRSsNP and CRSwNP.