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Cholesterol granulomas in antrochoanal polyps: a clinicopathologic study

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Abstract

The purpose of this study was to investigate antrochoanal polyps with cholesterol granuloma (CG), which is a granulomatous reaction to cholesterol crystals that has been precipitated in the tissue. It is usually associated with chronic middle ear disease, common in the mastoid air cells, less common in the orbit and rarely found in the paranasal sinuses. The aim of this study was to analyze the etiology and pathological findings of antrochoanal polyps associated with cholesterol granuloma. This is a retrospective study of five cases of antrochoanal polyp with cholesterol granuloma, (four males and one female between 15 and 77 years of age) who presented with nasal obstruction, rhinorhea and snoring. The cases were clinically and histologically reviewed. Four patients were treated endoscopically and one by intranasal polypectomy without endoscope. There was no recurrence during the follow-up between 24 to 36 months (mean 31.2 months). Five uncommon cases with antrochoanal polyp with cholesterol granuloma are presented. The cholesterol granulomas consist of fibrous granulation tissue containing cholesterol crystals with surrounding foreign body giant cells. The pathogenesis of antrochoanal polyp with cholesterol granuloma is unclear, and further investigations are needed.

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References

  1. al-Amer AF, Walia HS, Madda JP (1990) Cholesterol granuloma of the peritoneum. Can J Surg 33:410–413

    Google Scholar 

  2. Basak S, Karaman CZ, Akdilli A, Metin KK (1998) Surgical approaches to antrochoanal polyps in children. Int J Pediatr Otorhinolaryngol 46:197–205

    Google Scholar 

  3. Berg O, Carenfelt C, Silfversward C, Sobin A (1988) Origin of the choanal polyp. Arch Otolaryngol Head Neck Surg 114:1270–1271

    Google Scholar 

  4. Bundgaard N, Eriksen HE, Greisen O (1987) Inflamed adenolymphoma with cholesterol granuloma. J Laryngol Otol 101:967–970

    Google Scholar 

  5. Chen JM, Schloss MD, Azouz ME (1989) Antro-choanal polyp: a 10-year retrospective study in the pediatric population with a review of the literature. J Otolaryngol 18:168–172

    Google Scholar 

  6. Cook PR, Davis WE, McDonald R, McKinsey JP (1993) Antrochoanal polyposis: a review of 33 cases. Ear Nose Throat J 72:404–410

    Google Scholar 

  7. el-Guindy A, Mansour MH (1994) The role of transcanine surgery in antrochoanal polyps. J Laryngol Otol 108:1055–1057

    Google Scholar 

  8. Graham J, Michaels L (1978) Cholesterol granuloma of the maxillary antrum. Clin Otolaryngol 3:155–160

    Google Scholar 

  9. Gray WC, Salcman M, Rao KC, Hafiz MA (1985) Cholesterol granuloma of the petrous apex and sphenoidal sinus: a case report. Neurosurgery 17:67–69

    Google Scholar 

  10. Gunes HA, Almac A, Canbay E (1988) Cholesterol granuloma of the maxillary antrum. J Laryngol Otol 102:630–632

    Google Scholar 

  11. Henrik B. Hellquist (1990) Pathology of the nose and paranasal sinuses. Butterworth Ltd, Oxford, pp 74–76

  12. Kamel R (1990) Endoscopic transnasal surgery in antrochoanal polyp. Arch Otolaryngol Head Neck Surg 116:841–843

    Google Scholar 

  13. Kunt T, Ozturkcan S, Egilmez R (1998) Cholesterol granuloma of the maxillary sinus: six cases from the same region. J Laryngol Otol 112:65–68

    Google Scholar 

  14. Leon ME, Chavez C, Fyfe B, Nagorsky MJ, Garcia FU (2002) Cholesterol granuloma of the maxillary sinus. Arch Pathol Lab Med 126:217–219

    Google Scholar 

  15. Mills CP (1959) Secretory cysts of the maxillary antrum and their relation to the development of antrochoanal polyp. J Laryngol Otol 73:324–334

    Google Scholar 

  16. Min YG, Chung JW, Shin JS, Chi JG (1995) Histological structure of antrochoanal polyps. Acta Otolaryngol 115:543–547

    Google Scholar 

  17. Milton CM, Bickerton RC (1986) A review of maxillary sinus cholesterol granuloma. Br J Oral Maxillofac Surg 24:293–299

    Article  Google Scholar 

  18. Myatt HM, Cabrera M (1996) Bilateral antrochonanal polyps in a child: a case report. J Laryngol Otol 110:272–274

    Google Scholar 

  19. Nativ O, Mor Y, Nass D, Leibovitch I, Goldwasser B (1995) Cholesterol granuloma of the tunica vaginalis mimicking a neoplasm. Isr J Med Sci 31:235–236

    Google Scholar 

  20. Niho M (1986) Cholesterol crystals in the temporal bone and the paranasal sinuses. Int J Pediatr Otorhinolaryngol 11:79–95

    Google Scholar 

  21. Ophir D, Marshak G (1987) Removal of antral polyp through an extended nasoantral window. Laryngoscope 97:1356–1357

    Google Scholar 

  22. Ozdek A, Samim E, Bayiz U, Meral I, Safak MA, Oguz H (2002) Antrochoanal polyps in children. Int J Pediatr Otorhinolaryngol 65:213–218

    Article  Google Scholar 

  23. Rath-Wolfson L, Talmi YP, Halpern M, Levit I, Zohar Y, Gal R (1993) Cholesterol granulomas of the maxillary sinus presenting with nasal obstruction. Otolaryngol Head Neck Surg 109:956–958

    Google Scholar 

  24. Robson AK, Barker CS, Whittet HB (1990) Epistaxis as an unusual presentation of an antrochoanal polyp. J Laryngol Otol 104:643–644

    Google Scholar 

  25. Rubinstein A, Brenner S (1982) Idiopathic lipogranulomatosis of spleen and periaortic lymph nodes with noncaseating granulomas of liver. Hum Pathol 13:1133–1135

    Google Scholar 

  26. Salib RJ, Sadek SA, Dutt SN, Pearman K (2000) Antrochoanal polyp presenting with obstructive sleep apnea and cachexia. Int J Pediatr Otorhinolaryngol 54:163–166

    Article  Google Scholar 

  27. Stammberger H (1991) Functional endoscopic sinus surgery. BC Decker, Philadelphia

  28. Thevendran G, Al-Akraa M, Powis S, Davies N (2003) Cholesterol granuloma of the kidney mimicking a tumour. Nephrol Dial Transplant 18:2449–2450

    Article  PubMed  Google Scholar 

  29. Woolley AL, Clary RA, Lusk RP (1996) Antrochoanal polyps in children. Am J Otolaryngol 17:368–373

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Otolaryngology, Hasharon Hospital, Tel Aviv, Israel

    Itzhak Shvili & Raphael Feinmesser

  2. Department of Otolaryngology, Beilinson Hospital, Tel Aviv, Israel

    Tuvia Hadar, Jacob Shvero & Raphael Feinmesser

  3. Department of Pathology, Hasharon Hospital, Rabin Medical Center (affiliated with the Sackler Faculty of Medicine), Tel Aviv University, Petah Tikva, Tel Aviv, Israel

    Rumelia Koren

Authors
  1. Itzhak Shvili
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  2. Tuvia Hadar
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  3. Jacob Shvero
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  4. Raphael Feinmesser
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  5. Rumelia Koren
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Correspondence to Rumelia Koren.

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Shvili, I., Hadar, T., Shvero, J. et al. Cholesterol granulomas in antrochoanal polyps: a clinicopathologic study. Eur Arch Otorhinolaryngol 262, 821–825 (2005). https://doi.org/10.1007/s00405-004-0898-6

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  • DOI: https://doi.org/10.1007/s00405-004-0898-6

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