Differential Diagnosis of Chronic Rhinosinusitis with Nasal Polyps
Differential Diagnosis of Chronic Rhinosinusitis with Nasal Polyps
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DOI：
10.1159/000444957
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发表时间：
2016-01-01
期刊：
影响因子：
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通讯作者：
Reh, Douglas D.
中科院分区：
文献类型：
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作者：
London, Nyall R., Jr.;Reh, Douglas D.
鼻息肉是一种半透明的副鼻窦粘膜增生物，通常发生在慢性鼻窦炎（CRS）的情况下。鼻息肉还与哮喘、阿司匹林敏感性、囊性纤维化和过敏性真菌性鼻窦炎（AFS）有关。大多数鼻息肉是双侧的，其特征是组织水肿和嗜酸性粒细胞浸润。鼻息肉患者通常会出现鼻塞、鼻塞、鼻溢液或嗅觉改变等症状。鉴别诊断范围从良性肿块，如施奈德乳头状瘤，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。这些病变可能具有与鼻息肉相似的外观，如果肿块是单侧或先天性的，应特别注意鼻息肉的替代诊断。对单侧肿块患者的检查应包括放射影像学检查、可能的活检和适当时的仔细随访。本文就鼻息肉的病因及治疗方法作一综述，重点介绍鼻息肉的鉴别诊断及术后检查。(C)2016 S. Karger AG，巴塞尔
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. (C) 2016 S. Karger AG, Basel