Histopathological Spectrum of Lesions of the Nasal Cavity and Paranasal Sinuses: A Five-year Cross-sectional Study from a Tertiary Care Centre, Lucknow, India

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=[Introduction: Polyps or masses arising in the sinonasal area can disturb local anatomy and physiology with similar kinds of symptoms, including sneezing, epistaxis, respiratory obstruction and destruction of local structures. These lesions can be categorised as non-neoplastic or neoplastic. Advanced radiological techniques enable presumptive diagnosis; however, histopathological examination confirms the exact nature of the lesion (benign, malignant, or inflammatory). Aim: To investigate the histopathological spectrum of lesions arising in the nasal cavity, paranasal sinuses, nasopharynx and external nose and also to compare histopathological diagnosis in relation to age, sex and site of distribution. Materials and Methods: The present observational crosssectional study was conducted for one year (July 2018- June 2019), and data collection was done both prospectively (July 2018-June 2019) for one year and retrospectively (July 2014- June 2018) for four years was conducted at a Tertiary Care Centre, King George Medical University, Lucknow, Uttar Pradesh, India. A total of 967 cases of tissue samples were selected for study from the nasal cavity, paranasal sinuses, nasopharynx and external nose. All the relevant data like age, sex, complaints, site of lesion, diagnosis, immunohistochemical markers like Leukocyte Common Antigen (LCA) Pancytokeratin, S100 protein, Vimentin, Desmin, Cluster of Differentiation 99 (CD99) and special staining (periodic acid Schiff, Ziehl-Neelsen and Giemsa) were entered into an Excel sheet. Cases were categorised into nonneoplastic and neoplastic. Neoplastic was further divided into benign and malignant and compared in relation to age, sex and site of distribution. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) Statistics (version 21.0). Mean, standard deviation, Chi-square test, Analysis of Variance (ANOVA) and level of significance (p-value) were done. Results: A total of 967 sinonasal lesions were studied in patients aged eight months-85 years. The incidence was 11.1 cases/ year with a male-to-female ratio of 2.37:1. Non-neoplastic lesions formed 57.3% (558), benign 22.9% (223), and malignant 19.1% (186). The mean age for malignant cases (46.1 years) was higher than for benign ones (29.2 years). Inflammatory polyps 60.4% (337) were the commonest non-neoplastic lesion, angiofibroma 46.2% (103) he commonest benign, and squamous cell carcinoma 36% (67) the predominant malignant lesion. The nasal cavity was the most frequent site involved. Conclusion: The present study demonstrated a diverse range of histopathological lesions, from simple inflammatory to aggressive malignant lesions in the sinonasal area. It is very difficult to differentiate these lesions based on clinical and radiological parameters. Hence, histopathological examination is essential to categorise these lesions for the appropriate management of patients.

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