OBJECTIVE: To describe five rare cases of bilateral olfactory clefts respiratory epithelial adenomatoid hamartoma (REAH), and investigate the clinicopathologic features in REAH. METHOD: Five cases with REAH were reported and the relevant literatures were reviewed. All the cases were confirmed by pathology. RESULT: The chief complaint in 4 cases when visited was nasal obstruction and rhinorrhea, with or without hyposmia and headache. Another was discomfortable of head-facial region, sometimes with pus discharge and blood in nasal discharge. Polypoid neoplasms can be seen in nasal meatus of the 5 cases. Endoscopic sinus surgery was utilized to eliminate foci in 5 cases. All REAH foci located in bilateral olfactory clefts areas, four of which appeared polypoid changes,one appeared obvious inflammatory edema. All of them presented as wide-based lesion with tenacious quality compared to polyps. Histologically, these lesions were characterized by a glandular proliferation lined by ciliated respiratory epithelium originated from the surface epithelium, and the glands surround into round or oval, with various sizes and separated by stromal tissue. CONCLUSION It is possible to continue developing after operation, if REAH is not completely resected. Complete resection of lesions is the key to treatment success for this entity in endoscopic sinus surgery. Although REAH arising from the rhino sinusal region is very rare, rhinolaryngologists must know this entity in order to differentiate it from inverted papilloma and adenocarcinoma.
Adult ; Female ; Hamartoma ; pathology ; Humans ; Male ; Middle Aged ; Nasal Cavity ; pathology ; Nose Diseases ; pathology ; Olfactory Mucosa ; pathology ; Respiratory Mucosa ; pathology

Objective: To identify the differentially expressed genes in nasal epithelial cells from chronic rhinosinusitis with nasal polyps (CRSwNP), and to analyze related genes which are involved in deficiency of nasal epithelial barrier in CRSwNP patients by analyzing the datasets download from the gene expression omnibus(GEO) database. Methods: The mRNA expression microarray data numbered GSE107624 (7 CRSwNP and 7 controls) and GSE69093 (13 CRSwNP and 11 controls) were downloaded from the publicly available GEO database. These two datasets were jointly analyzed to screen the differentially expressed genes in nasal epithelial cells of controls and CRSwNP patients. In the meanwhile, we further evaluated the function annotation and regulatory pathways of the differentially expressed genes. To further confirmed what we have observed, sinus tissues were collected from patients with CRSwNP (14 cases, 46.8±17.9 years) and uncinate process tissues were collected from patients with nasal septum deviation (7 cases, 23.4±2.3 years) as control group. The primary epithelial cells of nasal mucosa were cultured and the mRNA level of screened genes were measured by Q-PCR. SPSS 22.0 software was used to for statistical analysis. Results: GSE107624 dataset showed that there were 3 856 differentially genes in nasal epithelial cells between CRSwNP and control group, while there were 771 differentially expressed genes in GSE69093 dataset. Finally, 55 up-regulated genes and 3 down-regulated genes were noticed in nasal epithelial cells of CRSwNP patients in the two datasets. GO gene functional annotation analysis showed that SPTBN1, FNBP1L, VAPB and SNX1 were involved in cell adhesion function, MAP1B was participated in the formation of microtubule related complex. KEGG pathway enrichment analysis indicated that BAMBI and SIAH1 were involved in regulation of Wnt pathway, COL6A1 and EIF4E were involved in the regulation of PI3K-AKT pathway. String protein interaction network analysis assumed that MAP1B and VAPB were the core functional proteins. Among top 3 differentially expressed genes COL6A1, MAP1B and BAMBI, only MAP1B gene was increased in nasal epithelial cells of CRSwNP patients in comparison to controls. Conclusion: The increased MAP1B gene in epithelial cells of CRSwNP, as well as abnormal regulation of Wnt and PI3K-AKT signal pathways may mediate the barrier dysfunction in CRSwNP.
Chronic Disease ; Epithelial Cells ; Gene Expression Profiling ; Humans ; Nasal Mucosa/pathology* ; Nasal Polyps/pathology* ; Phosphatidylinositol 3-Kinases ; Rhinitis/pathology*

OBJECTIVE: To study the relationship between the lymphoid follicles in mucous membrane of pharynx and mucosal associated lymphoid tissues (MALT). METHOD: Ten folliculi obtained from 10 patients of follicular pharyngitis and mucosa taken form 10 patients of paranasal sinusitis were fixed in neutral formalin and embedded in paraffin. Sections were prepared, stained by H. E and by immunohistochemical method staining with S-100,and observe by light microscopy. We observed the morphology of lymphoid follicles in mucous membrane of pharynx with MALT in mucosa of paranasal sinusitis as the contrast. RESULT: Lymphoid follicles in mucosa of pharynx compared with MALT in the mucosa of paranasal sinuses, there was no mantle zone, no typical germinal center and no mucosal epithelium, immunological staining with S-100 was week. CONCLUSION The lymphoid follicles in mucosa of pharynx does not belong to the MALT.
Chronic Disease ; Humans ; Immunohistochemistry ; Lymphoid Tissue ; pathology ; Nasal Mucosa ; pathology ; Paranasal Sinuses ; pathology ; Pharyngitis ; pathology ; Pharynx ; pathology ; Sinusitis ; pathology

Adult ; Female ; Humans ; Male ; Middle Aged ; Nasal Mucosa ; surgery ; Nasal Septum ; pathology ; Rhinoplasty ; Tissue Transplantation ; Treatment Outcome

Objective: To investigate the roles of hypoxic stimulation in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) by comparing the variation and differences of inflammatory factors secreted from epithelial cells of nasal polyps and normal nasal mucosa under hypoxic stimulation. Methods: Sixty-eight patients who were diagnosed with CRSwNP from June 2015 to January 2018 at China-Japan Union Hospital of Jilin University were analyzed, including 36 males and 32 females, aged (45.2±12.5) years. Nasal polyps mucosa was included in CRS-NP group and inferior turbinate mucosa was included in CRS-IT group. According to the degree of eosinophil infiltration in histopathologic results, each of these two groups was further divided into eosinophil infiltration and non-eosinophil infiltration as Eos-NP group (n=34), Non-Eos-NP group (n=34), Eos-IT group (n=20) and Non-Eos-IT group (n=20). The inferior turbinate mucosa of twenty-five patients who were diagnosed with cyst of paranasal sinus or deviation of nasal septum was classified as control group (n=25), including 14 males and 11 females, aged (42.8±10.2) years. The expression of interleukin 17A (IL-17A), interferon γ (IFN-γ), tumor necrosis factor α (TNF-α) and hypoxia-inducible factor 1α (HIF-1α) in each group was analyzed by immunohistochemical staining. After 0, 24 and 48 h hypoxic stimulation, the secretion of IL-17A, IFN-γ, TNF-α in primary nasal mucosa epithelial cells of each group was tested by enzyme-linked immune sorbent assay (ELISA) experiment; the expression of HIF-1α was tested by immunofluorescent staining and imaging and Western blot. SPSS 17.0 software and two-way ANOVA were used for statistical analysis. Results: Immunohistochemical staining showed that the expression of IL-17A and TNF-α was much higher in control group (optical density (OD) value was 0.37±0.03, 0.53±0.02, respectively) and the expression of IFN-γ and HIF-1α was much higher in Eos-IT group (OD value was 0.47±0.03, 0.39±0.02, respectively). The secretion of IL-17A and TNF-α was much lower in control group than that in other groups under normal condition. After 48 h hypoxic stimulation, the secretion of IL-17A and TNF-α was much higher in control group compared with other groups. The secretion of IFN-γ in Eos-NP group was much higher than that in control group under normal condition ((13.7±1.3) pg/ml vs (11.1±1.6) pg/ml, P<0.05). After 48 h hypoxic stimulation, there was no difference of IFN-γ between control group and Eos-NP group. The expression of HIF-1α decreased in Eos-NP group and Non-Eos-NP group while increased in CRS-IT group and control group upon prolonged exposure to hypoxia. HIF-1α was mostly located at cytoplasm of epithelial cells in control and CRS-IT group while mainly located at nucleus of epithelial cells in CRS-NP group. Conclusions: The secretion of IL-17A, TNF-α, IFN-γ and the expression of HIF-1α show significant difference between normal nasal mucosa, polyps and inferior turbinate of CRSwNP under hypoxic stimulation, presenting different subcellular localization. This illustrates the proteins above are involved in transcription and regulation of the gene responsible for the pathogenesis of CRSwNP.
Adult ; China ; Chronic Disease ; Epithelial Cells ; Female ; Humans ; Hypoxia/pathology* ; Male ; Middle Aged ; Nasal Mucosa/pathology* ; Nasal Polyps/pathology* ; Rhinitis/pathology*

Objective: To investigate the difference of concentrations of specialized pro-resolving mediators (SPMs) derived from fatty acids in eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) and non-eosinophilic chronic rhinosinusitis with nasal polyps (nECRSwNP). Methods: A total of 36 patients with bilateral chronic rhinosinusitis with nasal polyps (CRSwNP) who underwent endoscopic nasal surgeries in Peking Union Medical College Hospital from May 2019 to September 2020 were enrolled, including 27 males and 9 females, with the age from 13 to 67 years. There were 23 cases of ECRSwNP and 13 cases of nECRSwNP. At the same time, 12 control subjects were enrolled. The concentrations of multiple SPMs, including lipoxins (LXA₄ and LXB₄), resolvins (RvD₁, RvD₂, RvD₃, RvD₅ and RvE₁), protectins (PDX) and maresins (Mar-1) in nasal polyps with different histological subtypes and normal nasal mucosa were analyzed using liquid chromatography-tandem mass spectrometry. The concentrations of SPMs between groups were compared using Mann-Whitney U test. Spearman's rank correlation coefficient was used to measure the correlation between the concentrations of SPMs in nasal polyps and tissue eosinophil counts. Results: The concentrations of RvD₂, RvD₃, RvD₅, LXA₄, LXB₄, Mar-1 and PDX in ECRSwNP group were significantly higher than that in controls (Z value was -2.276, -2.313, -3.371, -2.094, -2.051, -3.104 and -2.294, respectively, all P<0.05). The concentrations of RvD₂, RvD₅, Mar-1 and PDX in ECRSwNP group were significantly higher than those in nECRSwNP group (Z value was -2.175, -2.289, -2.243 and -2.124, respectively, all P<0.05). There was no significant difference in all these SPMs between nECRSwNP and controls (all P>0.05). The concentrations of RvD₂, RvD₃, RvD₅, LXB₄, Mar-1 and PDX in nasal polyps correlated positively with tissue eosinophil counts (r value was 0.443, 0.436, 0.371, 0.502, 0.340 and 0.386, respectively, all P<0.05). Conclusions: A varienty of SPMs are elevated in ECRSwNP. Dysregulation of fatty acid metabolism might play an important role in the chronic inflammation of ECRSwNP.
Adolescent ; Adult ; Aged ; Chronic Disease ; Eosinophils ; Female ; Humans ; Male ; Middle Aged ; Nasal Mucosa/pathology* ; Nasal Polyps/pathology* ; Rhinitis/pathology* ; Sinusitis/pathology* ; Young Adult

Since the early part of the twentieth century, many authors have claimed that eosinophilia is found in the nasal secretions and blood of patients with allergic diseases. This observation has now become an established fact, and recent evidence based on extensive investigation, suggests that the eosinophil may play an active role in allergic disease. Thus, we report changes in nasal eosinophils in a group of nasal allergy patients treated by specific hyposensitization. The following results were obtained; 1. Eosinophilia was noted in 52.8 percent of untreated nasal allergy patients. 2. The eosinophilic count was gradually decreased with increasing S.D.V.(specific desensitizing vaccine) hyposensitization.
Eosinophils* ; Hay Fever/pathology* ; Human ; Leukocyte Count ; Mucus/cytology ; Nasal Mucosa/secretion*

Adult ; Female ; Humans ; Nasal Mucosa ; pathology ; Nose Neoplasms ; diagnosis ; surgery ; Papilloma ; diagnosis ; surgery

OBJECTIVES: To evaluate the functional and morphological changes of the nasal mucosa after radiotherapy in humans. MATERIALS & METHODS: We examined the pathology of the nasal mucociliary system by saccharine transport test and electron microscopy in 18 patients previously treated with radiation therapy. Each patient was asked about prevalence of nasal symptoms before and after radiation therapy with questionare. RESULTS: The patients who received radiation therapy had negative saccharine test results and noted higher prevalence of nasal crust, anosmia, epistaxis etc. after radiation therapy. There was the evidence of recovery from squamous metaplasia about 40 months after radiotherapy in electron microscopic examination. CONCLUSION: Although we could not confirm the results because of the small size of the samples and inconsistency of the duration and dosage of radiation, we found the evidence of recovery from squamous metaplsia. These results may be useful in taking counsel with patients about the complications of radiation therapy and the possibility of recovery of nasal symptoms.
Epistaxis ; Humans ; Metaplasia ; Microscopy, Electron ; Nasal Mucosa* ; Olfaction Disorders ; Pathology ; Prevalence ; Radiotherapy* ; Saccharin

Rhinogenic headache may be defined as a headache directly caused by pathology within the nose or paranasal sinuses. Rhinogenic headache is a controversial, but distinct type of headache that has received an increased amount of attention in the literature over the past twenty years. The International Classification of Headache Disorders, 3rd edition has been released by the 'International Headache Society' in May 2013. As this version is based on a large body of research on headache, in contrast to previous editions that were mostly based on opinion of experts, it is being considered as a major step forward in the diagnosis and management of headache. The International Headache Society presented the diagnostic criteria of rhinogenic headache divided into three types: Headache Attributed to Acute Rhinosinusitis, Headache Attributed to Chronic or Recurring Rhinosinusitis, Headache Attributed to Disorder of the Nasal Mucosa, Turbinates or Septum. We herein present the salient features of the new classification, which are likely to be of interest to the rhinologist. In addition, I review the evidence that intranasal mucosal contact points cause facial pain or headache and present the important points to consider in diagnosis and treatment of mucosal contact point headache.
Classification* ; Diagnosis ; Facial Pain ; Headache Disorders* ; Headache* ; Nasal Mucosa ; Nose ; Paranasal Sinuses ; Pathology ; Turbinates