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. 2022 Apr-Jun;63(2):413-419.
doi: 10.47162/RJME.63.2.12.

Allergic rhinitis associated with nasal polyps and rhinosinusitis - histopathological and immunohistochemical study

Andreea Iordache  1 , Nicolae Constantin Balica, Ioana Delia Horhat, Raluca Morar, Alina Andreea Tischer, Adina Iuliana Milcu, Mădălina Casiana Salavat, Veronica Mădălina Borugă, Bogdan Niculescu, Gheorghe Iovănescu, Zoran Laurenţiu Popa
Affiliations

Allergic rhinitis associated with nasal polyps and rhinosinusitis - histopathological and immunohistochemical study

Andreea Iordache et al. Rom J Morphol Embryol. 2022 Apr-Jun.

Abstract

Currently, allergic rhinitis (AR) is the most common allergic disease worldwide. AR is defined as immunoglobulin E (IgE)-mediated chronic inflammatory disease of the upper airways. It characterizes by symptoms like nasal obstruction, rhinorrhea, nasal itching, and sneezing. The immune system and genetic susceptibility in the interaction with the environment lead to the development of AR. Many cytokines, chemokines and cells maintain allergic inflammation. Studies show that 10% to 30% of the adult population are affected, and that prevalence rates are increasing world widely. AR, nasal polyps (NP), as well as chronic rhinosinusitis (CRS) are all associated with eosinophilic infiltration and large quantities of mast cells (MCs) within the mucosa. The diagnosis and management of chronic sinonasal diseases involves the analysis of eosinophilic infiltration, MCs, and their markers eosinophilic cationic protein (ECP) and tryptase. Regarding nasal cancer, nasal allergies were found to exhibit a dual function: immune surveillance may help in the defense against malignant cells, but an opposite effect is observed in tissues with chronic stimulation and inflammation. In the present paper, we studied a group of 70 patients diagnosed with AR and NP, rhinosinusitis or nasal cancer, admitted to the Ear, Nose & Throat (ENT) Clinic of the Emergency City Hospital, Timişoara, Romania, between January 2016 and December 2020, and we identified 37 (53%) patients diagnosed with AR and NP, 25 (36%) patients diagnosed with AR and rhinosinusitis, and eight (11%) patients diagnosed with AR and nasal cancer. The average age of the patients was 53 years old. Every patient included in the study was histopathologically and immunohistochemically diagnosed.

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Conflict of interest statement

The authors declare that they have no conflict of interests.

Figures

Figure 1
Figure 1
Image of the rhinosinusal mucosa, where there is observed the reduction of cilia from the surface of the epithelium, the widening of the intercellular spaces, the thickening of the basal membrane and a moderate inflammatory infiltrate in the lamina propria. Hematoxylin–Eosin (HE) staining, ×200.
Figure 2
Figure 2
Area of rhinosinusal mucosa with epithelium void of cilia, widening of the intercellular spaces, reduction in the number of caliciform cells and tendency to squamous metaplasia. The chorion is strongly infiltrated with inflammatory cells, mainly with eosinophils. HE staining, ×200
Figure 3
Figure 3
Rhinosinusal mucosa area with partial necrosis of the surface epithelium; the chorion presents a diffuse inflammatory infiltrate formed most of the eosinophils. HE staining, ×200
Figure 4
Figure 4
The gland of the rhinosinusal mucosa with hyperplasia and hypertrophy of the caliciform cells. HE staining, ×200
Figure 5
Figure 5
Microscopic image of the lamina propria that is strongly infiltrated with round mononuclear lymphocytes, plasma cells and granulocytes. Of the granulocytes, the presence of an increased number of eosinophils is observed. HE staining, ×200.
Figure 6
Figure 6
Area of the lamina propria strongly infiltrated with eosinophils. HE staining, ×400.
Figure 7
Figure 7
Image of rhinosinusal mucosa with a moderate content of B-lymphocytes in the lamina propria. Immunomarking with anti-CD3 antibody, ×200. CD3: Cluster of differentiation 3.
Figure 8
Figure 8
CD3-positive T-lymphocytes present in a large number both in lamina propria and in the cover epithelium. Immunomarking with anti-CD3 antibody, ×200
Figure 9
Figure 9
CD79a-positive B-lymphocytes and plasma cells present in a very large number in lamina propria. Immunomarking with anti-CD79a antibody, ×200. CD79a: Cluster of differentiation 79a.
Figure 10
Figure 10
Area of rhinosinusal mucosa with an abundant inflammatory infiltrate in lamina propria where macrophages are well represented. Immunomarking with anti-CD68 antibody, ×200. CD68: Cluster of differentiation 68
Figure 11
Figure 11
Rhinosinusal mucosa area with a moderate inflammatory infiltrate and a small number of macrophages. Immunomarking with anti-CD68 antibody, ×200.
Figure 12
Figure 12
Abundant inflammatory infiltrate with numerous mast cells in a full degranulation process. Immunomarking with the anti-tryptase antibody, ×200.
See this image and copyright information in PMC

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