Histological Biopsies in the Assessment of Rhinopharyngeal Lesions

Backround: The rhinopharynx is an area with limited access. Lesions usually cause vague symptoms or otitis media with effusion. Therefore diagnosis is often made in advanced stages of disease. The use of flexible and rigid endoscopes is potentially capable of changing this trend and allows an early diagnosis using histological biopsies.

Aim: The aim of the present paper is to assess the rate of malignancies in rhinopharyngeal biopsies.

Material and Methods: We reviewed rhinopharyngeal biopsy results of specimens taken the last 20 months in our department. There were 37 men (74%) and 13 women (26%). The average age of the patients was 47.5 years, with a median of 53.5 years. The range was from 16 to 74 years.

Results: From the 50 histological diagnoses, 39 patients (78%) had benign lesions, 9 (18%) had malignant lesions, and in 2 cases (4%) the pathologist suggested a repeat biopsy as the material was considered inadequate for proper diagnosis. The benign lesions were: (1) inflammatory in 12 cases (24%); (2) adenoids in 10 cases (20%); (3) benign cysts in 2 cases (4%); (4) fungal infection with coexisting atypia in 1 case (2%); and (5) others in 14 cases (28%). The malignant lesions were: (1) 5 undifferentiated carcinoma (WHO type 2b) (10%); (2) 2 nonkeratinazing squamous cell carcinoma (WHO type 2a) (4%); (3) 1 metastatic carcinoma from the larynx (2%); and (4) 1 plasmatocytoma (2%). The patients with the malignant lesions were all men.

Conclusions: Although the majority of cases had benign lesions, a significant percentage (20%) had various malignancies supporting the wide use of endoscopic assessment of the nasopharynx and rhinopharyngeal biopsies that may contribute to early diagnosis and management.