The Prevalence of upper respiratory tract lesions in pathology department, Beni-Suef University Hospital ( Histopathological and immunohistochemical Evaluation )

Document Type : Original articles


Pathology department, Faculty of Medicine, Beni-Suef University, Egypt


The nasal cavity, paranasal sinuses, pharynx, and larynx form a complex upper respiratory tract (URT) system and are susceptible to infections, tumor-like conditions and true neoplastic conditions. The aim of this study is to detect the prevalence of URT lesions, to detect the prevalence of different lesions in different ages and sexes and to detect the etiology and possible high risk factors whenever possible.  A total of 202 specimens of URT lesions were received at the pathology department, Beni-Suef University Hospital during the period from June 2017 to June 2021. All were evaluated histopatholgically. Of which, 59 were also evaluated immunohistochemically using anti-HPV Clone K1H8 antibody.  Nasal polyp was the most prevalent lesion followed by vocal polyp. There was a significant relation of squamous metaplasia with nasal polyps and also there was a significant relation of dysplasia with vocal polyps indicating careful follow up after excision. There was no significant relation between HPV and different lesions with squamous morphology suggesting it as uncertain risk factor.


Main Subjects

  1. Anbukkarasi, K., Ganapathy, H., & Thanka, J. (2021). A study of lesions of upper respiratory tract. Journal of pharmaceutical research international, 27-38.
  2. Thomas, M., & Bomar, P. A. (2018). Upper respiratory tract infection.‏
  3. Giacomini, P. G., Di Mauro, R., Martino, F., Passali, F. M., Crolla, C., & Di Girolamo, S. (2019). HPV infection and clinical profiles in laryngeal diseases. Ann. Ital. Chir, 90(5), 398-403.‏
  4. Kombe, A. J. K., Li, B., Zahid, A., Mengist, H. M., Bounda, G. A., Zhou, Y., & Jin, T. (2020). Epidemiology and burden of human papillomavirus and related diseases, molecular pathogenesis, and vaccine evaluation. Frontiers in public health, 8.‏
  5. Ghallab, A. F., Allam, A. F., Abdelhay, S. A., Abdelwahab, M. G., Elsayed, R. A., & Abdelalim, A. A. (2020). Study of the role of human papilloma virus and laryngopharyngeal reflux in adult vocal fold polyps. The egyptian journal of hospital medicine, 81(7), 2416-2421.‏
  6. Ismael, A. T., Al-Rawi, R. A., & AL-Nuaimy, W. M. (2016). Immunohistochemical evaluation of the frequency of human papillomavirus in cervical lesions in a sample from the north Iraqi population. Iraqi postgraduate medical journal, 15(2).‏
  7. Pushpalatha, K., Sreedevi, C. H., & Soujanya, R. (2017). A study on histomorphological spectrum of nasal polyp. Annals of pathology and laboratory medicine, 4(02).‏
  8. Jaison, J., & Tekwani, D. T. (2015). Histopathological lesions of nasal cavity, paranasal sinuses and nasopharynx. Annals of applied Bio-sciences, 2(2), 40-6.‏
  9. Khade, M. G., Patil, R. N., Kumbhalkar, D. T., Patil, S. B., & Umap, P. S. (2020). Clinicohistopathological profile of nasal and sinonasal lesions: a study from Central India. International journal of medical science and diagnosis research, 4(8).‏
  10. Vandarkuzhali, N. (2018). A study on the prevalence of fungal isolates among the rhinosinusitis patients at Coimbatore Medical College and Hospital, Coimbatore (Doctoral dissertation, Coimbatore Medical College, Coimbatore).‏
  11. Waghray, J. (2018). Clinical study of fungal sinusitis. International journal of otorhinolaryngology and head and neck surgery, 4(5), 1307.‏
  12. Lupoi, D., & Preda, M. (2020). Fungal rhinosinusitis between regular infection and aggressive life-threatening disease. Journal of contemporary clinical practice, 6(2), 86-92.‏
  13. Sebastian, S. K., Kumar, V. B., Gupta, M., & Sharma, Y. (2021). Covid assossiated invasive fungal sinusitis. Indian journal of otolaryngology and head & neck surgery, 1-4.‏
  14. We, J., Lee, W. H., Tan, K. L., Wee, J. H., Rhee, C. S., Lee, C. H., ... & Kim, J. W. (2015). Prevalence of nasal polyps and its risk factors: Korean National health and nutrition examination survey 2009-2011. American journal of rhinology & allergy, 29(1), e24-e28.‏
  15. Rettig, E. M., & D’Souza, G. (2015). Epidemiology of head and neck cancer. Surgical oncology clinics, 24(3), 379-396.‏
  16. Sharma, D. K., Sohal, B. S., Bal, M. S., & Aggarwal, S. (2013). Clinico-pathological study of 50 cases of tumours of larynx. Indian journal of otolaryngology and head & neck surgery, 65(1), 29-35.‏
  17. Ma, K., Sun, X., Ma, L., & Zhang, S. (2020). Expression of serum PTTG1 in laryngeal carcinoma and its correlation to prognosis. Clinical and experimental otorhinolaryngology, 13(1), 64.‏
  18. Malik, P., Yadav, S. P. S., Sen, R., Gupta, P., Singh, J., Singla, A., & Vashisht, S. (2019). The clinicopathological study of benign lesions of vocal cords. Indian journal of otolaryngology and head & neck surgery, 71(1), 212-220.‏
  19. Martins, R. H. G., Defaveri, J., Domingues, M. A. C., & e Silva, R. D. A. (2011). Vocal polyps: clinical, morphological, and immunohistochemical aspects. Journal of voice, 25(1), 98-106.‏
  20. Effat, K. G., & Milad, M. (2015). A comparative histopathological study of vocal fold polyps in smokers versus non-smokers. The journal of laryngology & otology, 129(5), 484-488.‏
  21. Jiang, W. X., Cao, P. P., Li, Z. Y., Zhai, G. T., Liao, B., Lu, X., & Liu, Z. (2019). A retrospective study of changes of histopathology of nasal polyps in adult Chinese in central China. Rhinology, 57(4), 261-267.‏
  22. Perić, A., Stoiljkov, M., Đokić, D., & Đurđević, B. V. (2021). Epithelial squamous metaplasia and dysplasia in inflammatory nasal polyps: an observational study. Ear, nose & throat Journal, 100(2), NP120-NP124.‏
  23. Nunes, R. B., Behlau, M., Nunes, M. B., & Paulino, J. G. (2013). Clinical diagnosis and histological analysis of vocal nodules and polyps. Brazilian journal of otorhinolaryngology, 79, 434-440.‏
  24. Yang, Y., & Wu, H. T. (2016). Clinical and pathological analysis of 1116 cases of vocal cord polyp. Journal of clinical otorhinolaryngology, head, and neck surgery, 30(15), 1187-1190.‏
  25. Delwar, A. H. M., Chowdhury, N. K., Rahman, M. S., Khan, A. M., & Hossain, A. B. M. T. (2020). Incidence and outcome of vocal cord polyp: an endoscopic experience and perception. Asian journal of research in surgery, 3(1), 12-18.
  26. Lewis, J. S., Westra, W. H., Thompson, L. D., Barnes, L., Cardesa, A., Hunt, J. L., ... & Ferlito, A. (2014). The sinonasal tract: another potential “hot spot” for carcinomas with transcriptionally-active human papillomavirus. Head and neck pathology, 8(3), 241-249.‏
  27. Effat, K. G., & Milad, M. (2015). A comparative histopathological study of vocal fold polyps in smokers versus non-smokers. The journal of laryngology & otology, 129(5), 484-488.‏
  28. Sarhan, N. A., Fathallah, M. A., Wahba, A. A., Rabie, A. M., Mousa, S. A., & Kabeel, A. A. (2020). Incidence of nasal polyps recurrence rate in patients with eosinophilic esophagitis after endoscopic endonasal surgery. International journal of medical arts, 2(4), 741-748.‏
  29. Zhao, Y., Chen, J., Hao, Y., Wang, B., Wang, Y., Liu, Q., ... & Zhang, L. (2022). Predicting the recurrence of chronic rhinosinusitis with nasal polyps using nasal microbiota. Allergy, 77(2), 540-549.‏
  30. Sham, C. L., To, K. F., Chan, P. K., Lee, D. L., Tong, M. C., & van Hasselt, C. A. (2012). Prevalence of human papillomavirus, Epstein–Barr virus, p21, and p53 expression in sinonasal inverted papilloma, nasal polyp, and hypertrophied turbinate in Hong Kong patients. Head & neck, 34(4), 520-533.‏
  31. Wang, H., Zhai, C., Liu, J., Wang, J., Sun, X., Hu, L., & Wang, D. (2020). Low prevalence of human papillomavirus infection in sinonasal inverted papilloma and oncocytic papilloma. Virchows Archiv, 476(4), 577-583.‏
  32. Hoffmann, M., Klose, N., Gottschlich, S., Görögh, T., Fazel, A., Lohrey, C., Rittgen, W., Ambrosch, P., Schwarz, E., & Kahn, T. (2006). Detection of human papillomavirus DNA in benign and malignant sinonasal neoplasms. Cancer letters, 239(1), 64–70.
  33. Takahashi, Y., Bell, D., Agarwal, G., Roberts, D., Xie, T. X., El-Naggar, A., Myers, J. N., & Hanna, E. Y. (2014). Comprehensive assessment of prognostic markers for sinonasal squamous cell carcinoma. Head&neck, 36(8), 1094-1102.
  34. Xu, Y., Liu, S., Yi, H., Wang, J., Dong, P., Li, X., & Yin, S. (2014). Human papillomavirus infection in 674 Chinese patients with laryngeal squamous cell carcinoma. PloS one, 9(12), e115914.
  35. Jansen, L., Buttmann-Schweiger, N., Listl, S., Ressing, M., Holleczek, B., Katalinic, A., ... & GEKID Cancer Survival Working Group. (2018). Differences in incidence and survival of oral cavity and pharyngeal cancers between Germany and the United States depend on the HPV-association of the cancer site. Oral oncology, 76, 8-15.‏
  36. Roh, H. J., Mun, S. J., Cho, K. S., & Hong, S. L. (2016). Smoking, not human papilloma virus infection, is a risk factor for recurrence of sinonasal inverted papilloma. American Journal of Rhinology & Allergy, 30(2), 79-82.‏
  37. Knör, M., Tziridis, K., Agaimy, A., Zenk, J., & Wendler, O. (2015). Human papillomavirus (HPV) prevalence in nasal and antrochoanal polyps and association with clinical data. PLoS One, 10(10), e0141722.‏
  38. Jaiswal, A. S., Tanwar, P., Irugu, D. V. K., Sikka, K., Monga, R., Thakar, A., & Verma, H. (2022). Human papilloma virus in the etiopathogenesis of allergic nasal polyposis: A prospective study. American journal of otolaryngology, 43(1), 103273.‏
  39. Iravani, K., Bakhshi, F., Doostkam, A., Malekmakan, L., Tale, M., Jafari, P., & Dowran, R. (2021). Detection of human papillomavirus (HPV) DNA in benign laryngeal lesions and role of cigarette smoking as an inducing factor. Virus Disease, 1-5.
  40. ‏Lewis, J. S., Westra, W. H., Thompson, L. D., Barnes, L., Cardesa, A., Hunt, J. L., ... & Ferlito, A. (2014). The sinonasal tract: another potential “hot spot” for carcinomas with transcriptionally-active human papillomavirus. Head and neck pathology, 8(3), 241-249.‏
  41. Kılıç, S., Kılıç, S. S., Kim, E. S., Baredes, S., Mahmoud, O., Gray, S. T., & Eloy, J. A. (2017, October). Significance of human papillomavirus positivity in sinonasal squamous cell carcinoma. In international forum of allergy & rhinology (vol. 7, no. 10, pp. 980-989).‏
  42. Nakagawa, T., Matsusaka, K., Misawa, K., Ota, S., Takane, K., Fukuyo, M., ... & Kaneda, A. (2017). Frequent promoter hypermethylation associated with human papillomavirus infection in pharyngeal cancer. Cancer letters, 407, 21-31.‏
  43. Abdulsamad, A. T., Abdulbaki, S., Al-Attar, H., & Alshareda, I. (2019). The association between human papilloma virus and laryngeal masses. Basrah journal of surgery, 25(2), 39-46.‏