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Sterile Nasal Septal Abscess in Ulcerative Colitis With Crypt Abscess-Like Neutrophilic Infiltration
Masakazu Murayama1,2, Yoshihito Tanaka2, Tomoyuki Yokose3
1Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Showa Medical University, Tokyo, Japan.
A rare sterile nasal septal abscess (NSA) was found as an extraintestinal manifestation of ulcerative colitis (UC). This case revealed unique crypt abscess-like structures in nasal mucosa, improving with immunosuppressive therapy.
Area of Science:
- Gastroenterology
- Otolaryngology
- Pathology
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Extraintestinal manifestations (EIMs) of UC can affect various organs.
- Nasal septal abscesses (NSAs) are rare complications.
Observation:
- A 40-year-old female with relapsed UC presented with nasal swelling and discharge.
- Computed tomography confirmed an anterior NSA.
- Initial treatment with antibiotics and drainage was unsuccessful.
Findings:
- Histopathology revealed crypt abscess-like neutrophilic infiltration in the nasal mucosa, mimicking colonic UC.
- Cultures were negative, indicating a sterile abscess.
- The patient improved with immunosuppressive therapy.
Implications:
- This is the first reported case of a sterile NSA with these specific histopathologic findings in UC.
- It expands the known spectrum of sinonasal manifestations in UC.
- Early recognition and immunosuppressive treatment are crucial to prevent complications like saddle nose deformity.
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