Rhinologists are currently trying to find evidence useful for classifying CRSwNP. The histopathological study of inflammatory cells in tissue and their tendency to form aggregates has shown promise in determining pathogenesis and predicting the clinical outcome.

This study’s primary purpose was to assess tissue eosinophil count, eosinophil aggregation, and their relationship to different CRSwNP phenotypes.

Researchers retrospectively assessed A consecutive series of 96 patients who underwent endoscopic sinus surgery for CRSwNP. This structured histopathological approach considered eosinophil count and eosinophil aggregates.

Patients’ clinical features included AFRS in 17 cases, NERD in 19 cases, and intrinsic asthma in 18 cases, extrinsic asthma in 21 cases, and allergy in 21 cases. Statistical analysis revealed more eosinophil aggregates in patients with NERD than in those with AFRS, intrinsic asthma, or extrinsic asthma. NERD patients had a significantly higher tissue eosinophil count than the other groups considered, apart from the AFRS ones.

In particular, the study concluded that the NERD patient group’s rhinosinusitis was sustained by a significantly more severe eosinophilic reaction than in the other groups. Structured histopathology can provide useful information for classifying CRSwNP on pathophysiological grounds.

Reference: https://journals.sagepub.com/doi/full/10.1177/1945892419878322