Histopathology of tumorlike masses present in the nasal cavity of equids from brazil article pdf available in ciencia rural 389. Rhinosporidiosis presenting as recurrent nasal polyps. Rhinosporidiosis is a disease affecting primarily the mucosa of nose, conjunctiva and urethra. A variety of benign and malignant lesions of the nasal cavity may present as polyps, hence all polyps need histological examination.
Aug 31, 2006 a microscopic diagnosis of rhinosporidiosis was made. A caution to clinicians in the evaluation of such patients 1,2,10. Definition rhinosporidiosis has been defined as a chronic granulomatous disease characterized by production of polyps and other manifestations of hyperplasia of nasal mucosa. Rhinosporidiosis is a granulomatous disease affecting the mucous membrane of nasopharynx, oropharynx, conjunctiva, rectum and external genitalia. Histopathological study of lesions of nose and paranasal sinuses. The next common non neoplastic polyp was due to rhinosporidiosis 31. Early diagnosis is essential since nasal discharge is principle route of transmission of the disease. Polypoidal lesions nasal cavity, histopathology rhinosporidiosis, rhinoscleroma, inverted.
The lesion was treated surgically, and he remains free of disease four years later. Aug 05, 2019 rhinosporidiosis is a chronic granulomatous infection of the mucous membranes that usually manifests as vascular friable polyps that arise from the nasal mucosa or external structures of the eye. A rare clinical entity daniel aliyu1, sadikku mallami sahabi2 1department of ear, nose and throat, usmanu danfodiyo university teaching hospital, sokoto, nigeria 2department of histopathology, usmanu danfodiyo university teaching hospital, sokoto, nigeria. Mar 19, 2009 rhinosporidiosis of the lacrimal sac and nasolacrimal duct has been documented and it has been suggested that the primary site of rhinosporidiosis is the lacrimal sac with downward spread to the nasal passages through the nasolacrimal duct. Pathologically, there is nasal polyposis and other manifestations like hyperplasia of nasal mucosa. The incidence of nasal masses and especially nasal polyps is approximately 1 to 4%. Keywords rhinosporidiosis, nasal mass, dapsone therapy, surgical excision, nasal obstruction. Rhinosporidiosis is a disease of cattle, horses, mules, dogs 12, and humans and is characterized by large polyps, tumors, or wartlike lesions on the nasal and ocular mucous membranes.
Vaginal and penile lesions may resemble condylomata, while rectal lesions may mimic prolapsed internal hemorrhoids. Rhinosporidiosis can be easily misdiagnosed as a neoplastic disease, and hence, it is necessary to educate the public and medical community about this emerging disease entity in our region. Few italian human cases of this disease have been previously reported in the literature. Rhinosporidiosis is a common disease entity in tropical countries. Jan 26, 2014 rhinosporidiosis etiologycyclepathologytreatmentcomplications. Its morphologic characteristics resemble those of coccidioides immitis. We report here a clinically unsuspected case of rhinosporidiosis, diagnosed correctly by intraoperative fnac, and later confirmed by histopathological examination. It may mimic other more malignant and vigorous pathologies of the involved part. These growths are highly vascularized, sessile or pedunculated and are considered to result from the growth of the spherules and the tissue response to. Acasereport anterior rhinoscopy and nasal endoscopy showed a fairly large friable fleshy mass, measuring 2.
Single case was reported in 50 years old male, presented with nasal mass, histology showed typical palisading at the periphery of the epithelial nests, giving the tumor a basaloid appearance. Among the non neoplastic lesions, there were 110 cases 62. Nasal rhinosporidiosis is characterised by the presence of a single pedunculated polyp, multiple sessile polyps or a combination of both. Human nasal rhinosporidiosis diagnostic pathology biomed. All lesions involved the entire nasal cavity and presented with a vascular. Rhinosporidiosis is a disease caused by rhinosporidium seeberi which primarily affects the mucosa. Causes of fungal infection rhinosporidiosis in dogs. Frequent bathing in stagnant water ponds is a risk factor for this infection. Nose and nasal cavity constitute a common site for polypoidal masses, granulomatous lesions as commonly encountered clinical and pathological entities revealing wide spread histopathological spectrum on histopathology. The mass was excised endoscopically and sent for histopathological examination. Diagnosis was established by histopathology of partially excised lesion with high index of suspicion for rhinosporidiosis due to strawberrylike appearance of fragile polypoidal mass. Rhinosporidiosis is mainly prevalent in south asian countries.
I am 31 years old and have had severe yeast infection for over 8 years. Rhinosporidiosis is a disease endemic to south india, sri lanka and some areas of the african continent. Pdf on jan 20, 2014, yb ngamdu and others published nasal. Clinical manifestations are variable based on the location of the granulomas and the diagnosis depends on history, identifying the. Histopathological lesions of nasal cavity, paranasal. University of maiduguriuniversity of maiduguri teaching hospital, maiduguri, nigeria. Nasal polyps histopathologic spectrum springerlink. Surgical treatment has been refined significantly over the past twenty years with the advent of endoscopic sinus surgery. The pathology of rhinosporidiosis wiley online library.
There is papillomatous hyperplasia of nasal mucous membrane with rugae formation. The majority of the nasal polyps sent for histology are simple polyps. Chronic inflammation of the nasal cavity rhinitis or the paranasal sinuses sinusitis, symptoms lasting more than 6 weeks sequel to acute rhinitis symptoms lasting 6 weeks or less, with development of secondary bacterial infection associated with deviated septum or nasal polyps. The nasal lesions can sometimes be confused with nasopharyngeal malignancy. A case of nasal rhinosporidiosis in a 17yearold patient from the middle belt area of nigeria is described, the first such case seen in 16 years since this centre was established. The definitive diagnosis of rhinosporidiosis is by histology of the biopsied tissue showing typical features pathognomonic of the disease. However, nasal polyps should be regarded as signs and not diagnosis, unless subject to histopathologyespecially when the case is of unilateral nasal polyps, as histopathological evaluation is mandatory to reach a confirmed diagnosis. The increased vascularity is responsible for excessive bleeding. We present a case of a 36yearold male presenting with proptosis due to involvement of nasolacrimal duct which is rare. In tuberculoid or intermediate leprosy, a skin biopsy may be required to demonstrate the bacillus. A microscopic diagnosis of rhinosporidiosis was made. The pathogen was first identified in 1892, and was comprehensively described in 1900 by seeber. Importance of histopathology in diagnosis of unilateral nasal polyps rameez shah 1, md.
Accumulation of mucous in the crypts seen with increased vascularity. On evaluation, there was a red friable mass filling left nasal cavity, with spores seen on the surface and bleeds on touch figure 1. Cases details all cases of nasal rhinosporidiosis which presented to ent. In addition to the human beings, its observed in other animals such as horses, bulls and fish. Rhinosporidium seeberi is a eukaryotic pathogen responsible for rhinosporidiosis, a disease which affects humans, horses, dogs, and to a lesser extent cattle, cats, foxes, and birds. Post operatively, he has been on regular follow up and is currently free of nasal rhinosporidiosis. Sykes, in canine and feline infectious diseases, 2014. We report a case of rhinosporidiosis at the lateral pharyngeal wall which is a very rare site for rhinosporidiosis to occur. The epithelium over the sporangia is thinned out, foreign body giant cells can be seen. Rhinosporidiosis is caused by rhinosporidium seeberi, which causes slowgrowing tumorlike masses in the nasal cavity. Mar 01, 2015 chronic inflammation of the nasal cavity rhinitis or the paranasal sinuses sinusitis, symptoms lasting more than 6 weeks sequel to acute rhinitis symptoms lasting 6 weeks or less, with development of secondary bacterial infection associated with deviated septum or nasal polyps. Rhinosporidiosis is a condition which both clinicians and pathologists should keep in mind when managing patients from endemic countries with nasal masses.
Results our patient had a recurrence of nasal lesions thrice. A case of nasal rhinosporidiosis occurred in a 73yearold man who has lived all his life in the united states. Although once thought to be a fungus, molecular methods have identified this organism as an aquatic protistan parasite class mesomycetozoea. Histopathological study of polypoidal lesions of the nasal. Patient was diagnosed as rhinosporidiosis and underwent excision of the mass thrice, in 1994, 2006 and 2017. Mar 02, 2012 they can be clearly seen with a hand lens.
It is a chronic granulomatous disease caused by the fungus rhinosporidium seeberi. Nasal polyps need to be differentiated from those in allergic disease. Importance of histopathology in diagnosis of unilateral nasal. Out of these 104 cases, 27 cases were neoplastic 25. In tuberculoid or intermediate leprosy, a skin biopsy may be required to demonstrate the. Pdf rhinosporidiosis is a chronic granulomatous lesion that is. The nasal mass was sent to the microbiology and pathology department for mycological investigations. Pdf histopathology of tumorlike masses present in the. Nasal polyps are one of the most frequent clinical entities encountered by otolaryngologists. Fungal infection rhinosporidiosis in dogs symptoms. To report a rare case of nasal rhinosporidiosis in a yearold male patient from sokoto, north western nigeria.
Recent advances in rhinosporidiosis and rhinosporidium seeberi. The rhinosporidiosis is a chronic and uncommon granulomatous disease, caused by rhinosporidium seberi. Patients with nasal involvement often have masses leading to nasal obstruction or bleeding due to polyp formation and it can spread to the nasopharynx, oropharynx, and the maxillary antrum, as was evident in one of our cases. Rhinosporidiosis is a relatively rare, chronic and recurrent granulomatous disease caused by rhinosporidium seeberi. The present study of histopathology of lesions of the nasal cavity, paranasal sinus and nasopharynx included 104 lesions encountered over a period of 5 years.
It typically involves the upper respiratory tract but can affect other parts of the body too and its lesions have a characteristic appearance. The definitive diagnosis of rhinosporidiosis is by histopathology on biopsied. Incidence, prevalence and histopathological categorization. It affects more commonly the nasal mucosa 70% of the cases, but it may affect the nasopharynx, conjunctiva, urethra and genitalia. Definitive diagnosis is by histopathology of the specimen. Rhinosporidiosis manifests as tumorlike masses, usually of the nasal mucosa or ocular, conjunctivae of humans and animals. The lesions that have developed in and around the nasal passage will continue to grow in size and should be surgically removed under general anesthesia for the overall comfort and safety of the canine. Figure 8 histopathology picture showing sporangia covered with multiple. Rhinosporidiosis may be suspected in subjects with polypoid lesions that contain white dots on close inspection. Histopathological lesions of nasal cavity, paranasal sinuses. During the study period, 21 cases of extra nasal rhinosporidiosis were diagnosed hisopathologically, among which 17 cases were undergone preoperative cytological evaluation. Analysis of 345 polypoidal masses in nose and nasal sinuses with clinical diagnosis of nasal polyp, observed in 10 years, revealed 175 50.
Nasal cavity, paranasal sinuses, nasopharynx rhinosporidiosis. Importance of histopathology in diagnosis of unilateral. Pdf rhinosporidiosis is a disease affecting primarily the mucosa of nose. This retrospective study was designed to include the cytologically diagnosed cases of rhinosporidiosis and to compare with final histopathology of the lesions. Rhinoscleroma is a chronic granulomatous disease of the nasal mucosa and upper respiratory tract, caused by klebsiella rhinoscleromatis, an encapsuted, nonsporulating, nonmotile gramnegative bacillus. A total of 21 cases of extranasal rhinosporidiosis were diagnosed in our study period of 18 months. Histopathology showed numerous sporangia with endospores confirming the diagnosis of rhinosporidiosis. Histopathological study of lesions of nose and paranasal.
Computed tomography of paranasal sinuses pnsshows left nasal. It is most commonly found in tropical areas, especially india and sri lanka. Rhinosporidiosis of the lacrimal sac and nasolacrimal duct has been documented and it has been suggested that the primary site of rhinosporidiosis is the lacrimal sac with downward spread to the nasal passages through the nasolacrimal duct. Introduction rhinosporidiosis is a chronic infection caused by rinosporidium seeberi that mainly affects the nasal and conjunctive mucosas, being able to affect other regions as. During the study period, 21 cases of extranasal rhinosporidiosis were diagnosed hisopathologically, among which 17 cases were undergone preoperative cytological evaluation. Contrary to ordinary polyps which often arise from the middle turbinate, rhinosporidiosis frequently involves the mucosal lining of the nasopharynx, anterior nares, inferior turbinate, septum or nasal floor. Rhinosporidiosis is a condition which both clinicians and pathologists should keep in mind when managing patients. Nasal rhinosporidiosis four cases relate and literature. It usually presents as reddish, friable, polypoidal mass that bleeds to the touch. Histopathology section of the nasal mucosa showing matured and.
Wenig, mary richardson, in modern surgical pathology second edition, 2009. The mass was also seen in the oropharynx extending down through the posterior nasal apertures. Clinicopathological study of rhinosporidiosis with special reference. Rhinosporidiosis is a chronic granulomatous infection of the mucous membranes that usually manifests as vascular friable polyps that arise from the nasal mucosa or external structures of the eye. Diagnosis of rhinosporidiosis was confirmed in all cases by histology with or without. Rhinosporidiosis an unusual cause of nasal masses gains prominence. Though the floor of the nose and inferior turbinate are the most common sites, the lesions may appear elsewhere too. To report a rare case of nasal rhinosporidiosis in a yearold. Jun 03, 2000 the etiologic agent of rhinosporidiosis, rhinosporidium seeberi, is an enigmatic microbe that has been difficult to classify. The rhinosporidium in the nose is restricted to the nasal mucous membrane and does not cross the muco cutaneous barrier.