title: Incidence of neoplasia in patients with clinically suspicious nasal lesions and the value of computed tomography imaging in diagnosis.
abstract: BACKGROUND
  There is no consensus as to whether all routine bilateral polypectomy specimens should be sent for formal histopathological diagnosis to exclude underlying neoplastic pathology. This study assessed the necessity for histopathological investigation as routine practice in cases of bilateral and unilateral nasal lesions by estimating the incidence of unexpected pathologies. It also evaluated the ability of computed tomography to predict histopathological diagnosis in patients with unilateral nasal lesions.
  
  
  METHODS
  A retrospective analysis was conducted of 98 patients undergoing nasal polypectomy over a 12-month period.
  
  
  RESULTS
  Five of 23 patients with a unilateral lesion on nasendoscopy had inverted papillomas on histopathological examination. None of the 75 patients with clinically bilateral lesions on nasendoscopy showed evidence of neoplasia on histopathological examination. Patients with inverted papillomas had significantly lower total Lund-Mackay scores than those with bilateral polyps. Asymmetry scores of inverted papilloma patients were significantly higher compared to both bilateral and unilateral polyps patients.
  
  
  CONCLUSIONS
  The results suggest that histopathological diagnosis is only necessary in unilateral lesion patients as no unexpected histopathological diagnoses were made in bilateral lesion patients. Computed tomography imaging may have a role in predicting histopathological diagnosis by demonstrating asymmetry and less overall sinus opacification in patients with neoplastic lesions.
authors: Department of Otolaryngology,Head and Neck Surgery, University of Edinburgh Hospitals,Scotland,UK.
authors: P
authors: P
authors: Asimakopoulos
authors: Department of Otolaryngology,Head and Neck Surgery, University of Edinburgh Hospitals,Scotland,UK.
authors: I
authors: I
authors: Hathorn
authors: Department of Pathology,Edinburgh Royal Infirmary,Scotland,UK.
authors: H
authors: H
authors: Monaghan
authors: Department of Otolaryngology,Head and Neck Surgery, University of Edinburgh Hospitals,Scotland,UK.
authors: A T
authors: AT
authors: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D009669:Nose Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D018308:Papilloma, Inverted / Q000453:epidemiology / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: Radiography