JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY) ›› 2018, Vol. 32 ›› Issue (3): 76-81.doi: 10.6040/j.issn.1673-3770.0.2017.355

Previous Articles     Next Articles

Characteristics of respiratory epithelial adenomatoid hamartomas in the nasal olfactory cleft on computed tomography

YU Qianqian1, GUAN Ge2, ZHANG Niankai1, LI Na1, WEN Junfeng3, LIU Tingting1, LIAN Yuanyuan1   

  1. Center of Organ Transplantation;3. Operating Room, Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong, China
  • Received:2017-08-16 Online:2018-05-20 Published:2018-05-20

PDF (PC)

386

Abstract: Objective To study the characteristic computed tomography(CT)features of respiratory epithelial adenomatoid hamartomas in the olfactory clefts and to explore the differences found between hamartoma and chronic sinusitis with nasal polyps on a CT scan. Methods (1) The CT findings of 17 patients with histologically proven respiratory epithelial adenomatoid hamartoma in the bilateral olfactory clefts were retrospectively reviewed and CT features were analyzed. (2) The widths of the olfactory fissure area and the total nasal cavity on axial and coronal CT of 17 patients with hamartoma, 36 patients with nasal polyps, and 41 normal persons were measured and the ratio of the olfactory cleft to the nasal width was calculated. Results The analysis showed that patients with hamartoma presented with a soft tissue shadow in the olfactory fissure zone of equi-density with gray matter, and the width of olfactory cleft was increased. Median olfactory cleft widths in the axial and coronal CT images were: hamartoma, 11.5 and 11.8 mm; nasal polyps, 7.5 and 7.8 mm; and control group, 5.4 and 5.4 mm, respectively. The differences among the groups were statistically significant(all P<0.001). Total nasal width was not significantly different among the groups in either scan orientation. The median olfactory cleft width and total nasal width ratios were 45.5% and 43.5% for the hamartoma group, 30.0% and 30.0% for the nasal polyp group, and 22.0% and 21.0% for the control group, respectively, in the axial and coronal planes. The differences among the groups were statistically significant(all P<0.001). Conclusion Compared to normal and nasal polyposis CT-scans, REAH significantly enlarges the olfactory clefts width and olfactory cleft width / total nasal width. The enlargement of olfactory cleft is one of the characteristic signs of REAH,and CT can be used as a basis for the differential diagnosis of hamartoma and nasal polyps. Especially bilateral symmetry broadening is more valuable in diagnosis, and an olfactory cleft width more than 10 mm should be considered highly suggestive of hamartoma.

Key words: Tomography, X-Ray, Nasal polyps, Hamartoma

CLC Number: 

  • R739.62
[1] Owens D, Alderson D, Garrido C. Nasopharyngeal hamartoma:importance of routine complete nasal examination[J]. J Laryngol Otol, 2004, 118(7):558-560.
[2] Metselaar RM, Stel HV, van der Baan S. Respiratory epithelial adenomatoid hamartoma in the nasopharynx[J]. J Laryngol Otol, 2005, 119(6):476-478.
[3] Wenig BM, Heffner DK. Respiratory epithelial adenomatoid hamartomas of the sinonasal tract and nasopharynx: a clinicopathologic study of 31 cases[J]. Ann Otol Rhinol Laryngol, 1995, 104(8):639-645.
[4] Hawley KA, Ahmed M, Sindwani R. CT finding of sinonasal respiratory epithelial adenomatoid hamartoma:a closer look at the olfactory clefts[J]. AJNR Am J Neuroradiol, 2013, 34(5):1086-1090.
[5] 付琳,刘鹏涛,杨本涛,等.鼻腔嗅裂区呼吸上皮腺瘤样错构瘤的CT和MRI表现[J].中华放射学杂志,2016,50(4):256-259. FU Lin, LIU Pengtao, YANG Bentao, et al. CT and MR findings of the respiratory epithelial adenomatoid hamartoma in the nasal olfactory[J]. Chin J Radiol, 2016, 50(4):256-259.
[6] Liang J, OMalley BW Jr, Feldman M, et al. A case of respiratory epithelial adenomatoid hamartoma[J]. Am J Otolaryngol, 2007, 28(4):277-279.
[7] Picciotti PM, Calò L, Mulè A, et al. Rhinosinusal bilateral hamartoma:a case report[J]. Auris Nasus Larynx, 2008, 35(4):569-571.
[8] Braun H, Beham A, Stammberger H. Respiratory epithelial adenomatoid hamartoma of the nasal cavity-case report and review of the literature[J]. Laryngorhinootologie, 2003, 82(6):416-420.
[9] 曹志伟,顾兆伟,边志刚,等.双侧嗅裂区呼吸道上皮腺瘤样错构瘤临床病理特点[J].临床耳鼻咽喉头颈外科杂志,2010,24(11):507-510. CAO Zhiwei, GU Zhaowei, BIAN Zhigang, et al. Clinicopathologic features of respiratory epithelial adenomatoid hamartoma of bilateral oifactory clefts[J]. J Clin Otorhinolaryngol Head Neck Surg(China), 2010, 24(11):507-510.
[10] 邰旭辉,罗秀波,訾龙,等.鼻腔呼吸道上皮腺瘤样错构瘤14例报告[J].临床耳鼻咽喉头颈外科杂志,2014,28(23):1852-1855. TAI Xuhui, LUO Xiubo, ZI Long, et al. Clinical analysis of 14 cases with nasal respiratory epithelial adenomatoid hamartom[J]. J Clin Otorhinolaryngol Head Neck Surg(China), 2014, 28(23):1852-1855.
[11] Kessler HP, Unterman B. Respiratory epithelial adenomatoid hamartoma of the maxillary sinus presenting as a periapical radiolucency: a case report and review of the literature[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2004, 97(5):607-612.
[12] Malinvaud D, Halimi P, Côté JF, et al. Adenomatoid hamartoma of the ethmois sinus: one case report[J]. Rev Laryngol Otol Rhinol(Bord), 2004, 125(1):45-48.
[1] SONG Xiaoyu, ZHANG Yu, LI Chenglin, SONG Xicheng. Enhanced recovery after surgery for the treatment of chronic rhinosinusitis with nasal polyps [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(5): 9-12.
[2] HUANG Yuan, BA Luo, LI Bo, YU Wenxing, YANG Fangli, DU Jintao. Transcription factor NKX2-1 regulates eosinophilic inflammation in chronic rhinosinusitis with nasal polyps [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 17-23.
[3] CHEN Wangxing, ZHAO Xue, LIU Yan, LIU Yue, JIN Chunshun. Psychological status of patients with deviated nasal septum or chronic sinusitis with nasal polyps [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 24-27.
[4] Effect of short-term glucocorticoid inhalation on nasal symptoms and adrenocortical function in patients with eosinophilic chronic sinusitis accompanied by nasal polyps. Effect of short-term glucocorticoid inhalation on nasal symptoms and adrenocortical function in patients with eosinophilic chronic sinusitis accompanied by nasal polyps [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 28-31.
[5] LI Huabin, LAI Yuting. Pathogenesis, diagnosis, and treatment of chronic rhinosinusitis [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 4-9.
[6] LI Hongmei, WANG Lan, GAO Zhaohui, WANG Ying, XUE Jinmei. The expression and significance of p-ERK2/ ERK2 in nasal polyps [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 42-46.
[7] ZHANG Jie, GONG Qi. Clinical significance of eosinophils and neutrophils in blood and allergic reaction in patients with chronic rhinosinusitis [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 54-57.
[8] GAN Bin, ZHANG Yongju, XU Anting. BRF2 in the pathogenesis of chronic rhinosinusitis with nasal polyps [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 47-53.
[9] ZHI Lili, SONG Daoliang. Expressions of eosinophils and IL5 in antrochoanal polyps and nasal polyps. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(4): 43-46.
[10] LUN Jie, ZHANG Ya′nan. Analysis on the factors related to the recurrence of chronic rhinosinusitis with nasal polyps. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(3): 80-83.
[11] WANG Haipeng, XU Huijuan, ZHANG Xiufang, WANG Huizhong, LI Yanzhong. The application of Sinus Jel in adult patients of nasal polyps with sleep-disordered breathing. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(5): 58-60.
[12] SU Yi, XIE Jinghua, PAN Xiaoli, ZENG Guoqing. Efficacy and associated factors of endoscopic sinus surgery on patients with chronic rhinosinusitis with or without nasal polyps. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(4): 86-89.
[13] LI Houjie, QU Qian, XU Shicai, LIU Lingbing, ZHANG Yongchao, WANG Xuzeng, LIU Lei. Clinical experience on the treatment of antrochoanal polyp under nasal endoscopy by expand road of the combined middle-inferior meatus. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(2): 62-64.
[14] ZHANG Jian, LU Xiaoqing, WU Jian.. Differentially expressed proteins between nasal polyps and normal nasal mucosa by the iTRAQ technology. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(1): 5-8.
[15] DU Zhihong, YU Yafeng.. Effect of NLRP3 inflammasome in the pathogenesis and relapse of eosinophilic nasal polyps. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(1): 31-35.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd