Helliwell Tim
is a Reader in the Division of Pathology, University of Liverpool, Liverpool, UK. Conflicts of interest: none.
Diagn Histopathol (Oxf). 2010 Jun;16(6):255-264. doi: 10.1016/j.mpdhp.2010.03.008. Epub 2010 Apr 21.
Inflammatory diseases of the nose and paranasal sinus are commonly encountered in diagnostic histopathology. This review describes the possible manifestations of the common diseases as well as highlighting some of the uncommon causes of sinonasal inflammation which may have importance for treatment and prognosis. The diagnosis of fungal sinusitis is primarily histological. It is important to distinguish between invasive and non-invasive fungal sinusitis, the latter including allergic fungal sinusitis characterized by 'allergic mucin' and scanty fungal hyphae. Nasal eosinophilia is a feature of both allergic and non-allergic rhinosinusitis and a wide range of secondary changes in inflammatory polyps may lead to diagnostic confusion. Nasal biopsies are often taken from perforations or inflammatory masses to confirm or exclude granulomatous diseases. There is a broad differential diagnosis for granulomatous sinonasal disease and pathologists should appreciate the diagnostic histological and clinical features of these conditions.
鼻和鼻窦的炎性疾病在诊断性组织病理学中很常见。本综述描述了常见疾病的可能表现，并强调了一些鼻窦炎症的罕见病因，这些病因可能对治疗和预后具有重要意义。真菌性鼻窦炎的诊断主要依靠组织学检查。区分侵袭性和非侵袭性真菌性鼻窦炎很重要，后者包括以“过敏性黏液”和少量真菌菌丝为特征的变应性真菌性鼻窦炎。鼻嗜酸性粒细胞增多是变应性和非变应性鼻-鼻窦炎的特征，炎性息肉的一系列继发性改变可能导致诊断混淆。鼻活检通常取自穿孔或炎性肿块，以确诊或排除肉芽肿性疾病。肉芽肿性鼻窦疾病的鉴别诊断范围广泛，病理学家应了解这些疾病的诊断性组织学和临床特征。
