Clinical History:

A 39-year-old man has been bothered by nasal congestion with watery eyes and sneezing every spring and summer for many years. He now has increasing difficulty breating through his nose. Examination of his nose reveals several 1 to 2 cm glistening masses occluding each nostril. These masses are excised. Sometimes these polyps can become eroded and secondarily infected.

Microscopic Pathology:

At low and high power, there is an edematous stroma with scattered acute (mostly eosinophils) and some chronic inflammatory cells in the polypoid mass.

Questions:

1. What is the diagnosis?

Allergic nasal polyps. These are occasionally a complication of persons who have atopy with hay fever. The polyps can become large enough to produce airway obstruction. They are easily excised.

2. What is the pathogenesis?

Chronic allergic rhinitis with type I hypersensitivity to a variety of allergens, results in inflammation of nasal mucosal membranes. The acute and chronic inflammation with edema results in development of polypoid excrescences. Such polyps are rare in the pediatric age group and are most often seen in persons over 30 years of age.