上颌窦源性后鼻孔息肉临床与病理学特征的研究

RESEARCH ON CLINICAL AND PATHOLOGICAL CHARACTERISTICS OF ANTROCHOANAL POLYPS

[目的]分析上颌窦来源的后鼻孔息肉临床表现及病理特征。[方法]回顾性分析42例确诊为上颌窦来源的后鼻孔息肉患者的临床资料。对息肉组织石蜡包埋标本切片,HE染色光镜下观察病理学特点。[结果]3年随访治愈率达100%。上颌窦源性后鼻孔息肉的临床特点:①单侧发病;②以单侧进行性鼻阻为主诉症状;③多为单个息肉;④息肉源于上颌窦口窦内侧,蒂部悬于后鼻孔,上颌窦内为一薄壁囊肿,破溃后常有淡黄色液体流出。病理学特征:息肉被覆假复层纤毛柱状上皮,黏膜下炎性细胞浸润,主要为中性粒细胞,嗜酸性细胞浸润较少见,杯状细胞较多,间质水肿,并有潴留囊肿形成,内有炎性潴留物。[结论]上颌窦源性后鼻孔息肉的特殊病理特征及临床表现说明其发病机制可能存在特殊性,临床治疗也应区别对待。

[ Objective] To explore the clinical manifestation and pathological characteristics of antrochoanal polyps. [ Methods ] The clinical data of 42 cases of antroehoanal polyps were analyzed retrospectively. The polypi from these patients were fixed in formalin and embedded in paraffin, then the specimens were stained with HE to observe pathological characteristics under light microscope. [Results] All 42 patients were cured after 3 years＇ follow up. The antrochoanal polyps were usually unilateral. The main symptom was progressive nasal obstruction. Macroscopically, the polypi had a cystic intra-maxillary sinus portion and a solid intranasal portion, were covered by pseudostratified ciliated columnar epithelium. The inflmnmatory cell infiltration in submucous tissue was mainly that of neutrophilic granulocyte but with few acidophilic cell. Goblet cells edema and cyst were also found in the submucous tissue. [ Conclusions] The pathological characteristics and clinical features indicate that antrochoanal polyps have a different pathogenesis compared with the usual nasal polyps, so the clinical treatment of antrochoanal polyps should be different from that of the usual nasal polyps.