London Nyall R, Reh Douglas D
Adv Otorhinolaryngol. 2016;79:1-12. doi: 10.1159/000444957. Epub 2016 Jul 28.
Nasal polyps are semi-translucent mucosal outgrowths of the paranasal sinuses which typically arise in the setting of chronic rhinosinusitis (CRS). Nasal polyps are also associated with asthma, aspirin sensitivity, cystic fibrosis and allergic fungal rhinosinusitis (AFS). The majority of nasal polyps are bilateral and characterized by tissue edema and eosinophil infiltration. Patients with nasal polyps often present with complaints including nasal obstruction, congestion, rhinorrhea or altered sense of smell. The differential diagnosis ranges from benign masses such as schneiderian papilloma, antrochoanal polyp, angiofibroma and encephalocele to malignant neoplasms such as squamous cell carcinoma (SCC), esthesioneuroblastoma, nasal lymphoma and rhabdomyosarcoma. These lesions may have a similar appearance as nasal polyps and particular attention to an alternative diagnosis for nasal polyps should be entertained if the mass is unilateral or congenital in nature. Workup for patients with a unilateral mass should include radiographic imaging, possible biopsy and careful follow-up when appropriate. Here, we review the disease etiology of nasal polyps and describe the approach to the patient with nasal polyps with emphasis on differential diagnosis and workup.
鼻息肉是鼻窦的半透明黏膜增生，通常发生于慢性鼻-鼻窦炎（CRS）的背景下。鼻息肉还与哮喘、阿司匹林敏感性、囊性纤维化和变应性真菌性鼻-鼻窦炎（AFS）相关。大多数鼻息肉是双侧的，其特征为组织水肿和嗜酸性粒细胞浸润。鼻息肉患者常表现出鼻塞、充血、流涕或嗅觉改变等症状。鉴别诊断范围从良性肿物如内翻性乳头状瘤、上颌窦后鼻孔息肉、血管纤维瘤和脑膨出到恶性肿瘤如鳞状细胞癌（SCC）、嗅神经母细胞瘤、鼻淋巴瘤和横纹肌肉瘤。这些病变可能与鼻息肉外观相似，如果肿物本质上是单侧或先天性的，则应特别考虑鼻息肉的其他诊断。单侧肿物患者的检查应包括影像学检查、可能的活检以及在适当情况下进行仔细随访。在此，我们回顾鼻息肉的疾病病因，并描述鼻息肉患者的诊疗方法，重点是鉴别诊断和检查。
