Abstract

To study histopathological patterns of nasal cavity and paranasal sinuses lesions, to categorize them and to correlate them with age and gender and sociodemographic data. METHODOLOGY: Hospital based observational study was conducted in Department of Pathology ,Dr. S.N. Medical College, Jodhpur on Paraffin block of cases that fulfilled the inclusion criteria. Patient name, age, gender, registration number, path number, type of biopsy specimen and its gross feature was noted. The specimens were received in 10% formalin along with requisition form which also included the clinical data. The material was processed as routine histopathological examination, special stains were done wherever required. RESULTS :-Total 74 cases were analyzed, and lesions were classified as neoplastic and non neoplastic (inflammatory) and neoplastic were further classified as benign and malignant. Tumor were of nasal cavity and paranasal sinus were classified according to WHO classification and observation compared with other studies. . Nasal cavity(61.18%) was more effected by non neoplastic and neoplastic lesions than paranasal sinus (38.82%), Nasal obstruction was the most common presenting symptoms followed by nasal masses. 71.19% of the cases showed a unilateral presentation as the most common side.Most common non neoplastic lesion was nasal polyp with 43 cases which includes 95.65% of all nasal masses. Nasal polyps were most common in the third decade of life and showed an M:F ratio of 1:1.03.Allergic polyp were much more common then non allergic polyp. The other non-neoplastic lesions also observed were Rhinoscleroma, Mucormycosis, tuberculosis, chronic rhinitis and chronic sinusitis in population.Most common benign neoplastic lesions were haemangioma with 4 cases which constituted 30.77% of all benign neoplastic lesions and showed a high incidence in the sixth decade of life with female predominance. . Most common malignant nasal mass is squamous cell carcinoma constituting 53.33% of all lesions. Out of 8 cases males were more commonly effected by malignant lesions in the fifth and sixth decade of life.Second most comman malignant lesion observed was basal cell carcinoma it was 40% of all malignant lesions commonly nodular type followed by nasopharyngeal carcinoma (6.67%) more common in fifth and sixth decade of life.DISCUSSION;- Most of the nasal cavity lesions present with non specific and overlapping symptoms. From the clinical and macroscopic examination it is difficult to comment on the nature of the lesion. A careful histopathological examination is needed for a definitive diagnosis. Sinonsal masses have various differential diagnosis. Malignant lesions should be distinguished from non malignant lesions. The objectives of this study was to study the histopathological patterns, proportion of various lesions in the nasal cavity and paranasal sinuses and to correlate histomorphological features with their clinical features CONCLUSION :-From this study it is quite evident that masses in the nasal cavity and paranasal sinuses form a complex and wide spectrum of lesions ranging from non-neoplastic lesions to benign and malignant neoplastic lesions. Non neoplastic lesions were more comman than neoplastic lesions Sinonasal polyps were the most common lesions in the present study ,the age incidence ranges from 1st decade to 7th decade. There was slight female preponderance. Maximum number of non-neoplastic lesions were found in the third decade of life, benign and malignant neoplastic lesions were found in the fifth decade of life. Histopathological examination is very important in diagnosing the lesions. All the cases were classified according to WHO classification 2017. The age of incidence of nasal masses ranged from seven to eighty with an almost equal sex predilection and overlapping presentation. This may cause a diagnostic dilemma for the accurate and timely diagnosis and intervention which signifies the need of a more accurate diagnostic method.Features like nasal bone involvement, necrosis and epistaxis suggestive of malignancy were also seen in fungal infections like Mucormycosis and Aspergillosis. There were specimens with dual lesions which was almost impossible to diagnosed clinically.

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