Aim: Our goal was to determine the histological profile of ENT lesions. Method: We carried out a retrospective and descriptive study in the ENT department and Cervico-Facial Surgery at the university hospital center Gabriel Touré (MALI) from 1995 to 2014. It made it possible to collect 450 cases. Result: We found a male predominance; 51.11% or a sex ratio of 1.04. The mean age of patients was 38.04 years with a standard deviation of 19.49 years and extremes of 3 months and 91 years. Benign tumors were the most frequent (154 cases or 34.22%) including 75 cases of adenomas and 43 cases of papillomas. Cancers accounted for 48.11% (or 153 cases) of all tumors and 34% of lesions. Carcinomas accounted for 81.04%, malignant lymphomas 13.72% and sarcomas 5.22% of cases. Among the 140 cases (31.11%) of inflammatory pseudotumors, we found 12 cases of tuberculosis and 15 cases of rhinoscleroma. Three (3) cases of dysplasia were observed. Conclusion: Interest should be focused on histology in order to initiate appropriate therapy.
Otorhinolaryngology (ENT) disorders are one of the main reasons for consultation in General Medicine and Pediatrics [
The head and neck tumoral pathology includes benign tumors, cancers and inflammatory pseudo-tumors [
Our goal was to determine the histological profile of ENT lesions.
This is a retrospective and descriptive study of ENT and Cervico-facial lesions, histologically examined, collected in the ENT department and cervico-facial surgery of the Gabriel Toure University Hospital Center from 1995 to 2014.
The study focused on patients with upper airborne (VADS) or cervicofacial lesions that were subjected to tissue sampling in consultation, hospitalization, or the operating room for pathological examination. The fixation was carried out with formalin on the spot, then the samples sent to the laboratory of Pathological Anatomy in vials.
450 patients were selected with a precise histological diagnosis and a precise localization of the lesion in the period indicated above.
Patients who did not receive pathological examination, or a doubtful diagnosis, or those with two or more discordant results, unspecified anatomical site, poorly performed specimens and lesions whose date of diagnosis did not correspond to the period indicated above have been excluded.
We carried out a systematic examination of the anatomopathological results of the patients. The data was entered on Excel 2013 and the analysis was done on SPSS 20.0. The statistical test is used with Chi2 with P < 0.05.
The variables concerned sociodemographic data, the anatomical site of the lesion, the benign or malignant nature and the histological type.
Over 20 years, we collected 450 cases. The male sex (
The nasolabial lesion site accounted for 26% followed by larynx with 21.33% (
Age class (year) | Sex | Total | |
---|---|---|---|
Male | Female | ||
0 - 9 | 20 | 17 | 37 |
10 - 19 | 30 | 31 | 61 |
20 - 29 | 22 | 41 | 63 |
30 - 39 | 35 | 43 | 78 |
40 - 49 | 32 | 27 | 59 |
50 - 59 | 39 | 31 | 70 |
60 - 69 | 32 | 19 | 51 |
70 and over | 20 | 11 | 31 |
Total | 230 | 220 | 450 |
Seat | Effective | Frequency | Cumulative Frequency |
---|---|---|---|
Larynx | 96 | 21.33 | 21.33 |
Hypopharynx | 12 | 2.67 | 24.00 |
Oropharynx | 19 | 4.22 | 28.22 |
Cavum | 9 | 2.00 | 30.22 |
Oral cavity | 34 | 7.56 | 37.78 |
Nose and sinus | 117 | 26.00 | 63.78 |
Salivary glands | 33 | 7.33 | 71.11 |
Thyroid | 52 | 11.56 | 82.67 |
Hear | 16 | 3.56 | 86.22 |
Ganglion | 42 | 9.33 | 95.56 |
Esophagus | 7 | 1.56 | 97.11 |
Trachea | 1 | 0.22 | 97.33 |
Bronchi | 1 | 0.22 | 97.56 |
Other | 11 | 2.44 | 100.00 |
Total | 450 | 100.00 |
Other: Temporal region, Back-to-auricular region, Sub mental region, Supraorbital region, Frontal region, Upper maxillary.
The histological result revealed a predominance of benign tumor with 154 cases (34.22%) (
Histology | Effective | Frequency | |||
---|---|---|---|---|---|
Malignant neoplasms | carcinoma | 124 | 153 | 27.55% | 34% |
lymphoma | 21 | 4.66% | |||
Sarcoma | 8 | 1.77% | |||
Benign tumors | adenoma | 75 | 154 | 16.66% | 34.22% |
fibroma | 9 | 2% | |||
birthmark | 13 | 2.88% | |||
neurogangliome | 1 | 0.22% | |||
Papilloma | 43 | 9.55% | |||
chondroma | 1 | 0.22% | |||
osteoma | 2 | 0.44% | |||
Lipoma | 3 | 0.66% | |||
meningioma | 2 | 0.44% | |||
Lipomyxome | 1 | 0.22% | |||
histiocytoma | 1 | 0.22% | |||
benign ulcer | 1 | 0.22% | |||
sinus histiocytosis | 2 | 0.44% | |||
Inflammatory pseudo-tumors | inflammatory polyp | 23 | 140 | 5.11% | 31.11% |
Benign cyst | 11 | 2.44% | |||
non specific chronic inflammations | 58 | 12.88% | |||
trichinellosis | 1 | 0.22% | |||
tuberculosis | 12 | 2.66% | |||
sclérome | 15 | 3.33% | |||
glandular hamartoma | 1 | 0.22% | |||
pyogenic granuloma | 1 | 0.22% | |||
hyperplasia | 4 | 0.88% | |||
thyroiditis | 3 | 0.66% | |||
chronic laryngitis | 10 | 2.22% | |||
acute granuloma | 1 | 0.22% | |||
Dysplasia | 3 | 0.66% | |||
Total | 450 | 100% |
Benign neoplasms vs. Malignant: Pr (|Z| > |z|) = 0.9676. Benign neoplasms vs. Inflammatory pseudo-tumors: Pr (|Z| > |z|) = 0.5981. Malignant neoplasms vs. Inflammatory pseudo-tumors: Pr (|Z| > |z|) = 0.5703. Malignant neoplasms vs. dysplasia: Pr (|Z| > |z|) = 0.3161. Benign neoplasms vs. dysplasia: Pr (|Z| > |z|) = 0.3193.
Among benign tumors adenomas are the most common with 75 cases (i.e. 16.67% of all ENT and cervico-facial lesions or 48.70% of benign tumors or 24.42% of all true tumors of our series). There is a female predominance of benign tumors with a sex ratio of 0.61.
They are observed at all ages with a higher frequency in the age group 10 - 29 years (50 cases or 32.46% of benign tumors). After the adenomas come papillomas with 43 cases (i.e. 27.92% of benign tumors and 9.55% of all ENT lesions).
We found 153 cases (34%) of malignant tumors including 124 cases of all types of carcinoma (representing 27.56% of all ENT and cervicofacial lesions or 40.39% of the cases of tumors observed or 81.04 % of cancers). A predominance of these malignant lesions was found in the larynx with 45 cases (i.e. 10% of all ENT lesions or 29.41% of cancers or 14.65% of true tumors); followed by nose and sinuses (30 cases, i.e. 19.60% of cancers or 9.77% of true tumors or 6.66% of all lesions). A male predominance of these cancers was observed with a sex ratio of 2.19. They were seen at all ages with a higher frequency in the age group 50 - 59 years with 31 cases (20.26%).
• Squamous cell carcinoma
Squamous cell carcinoma accounted for 67.32% (103 cases) of all cancers, 83.06% of carcinomas and 22.88% of all lesions. In 72.72%, this was a male subject.
• Lymphoma
Lymphomas were seen almost at all ages 0 to 70 years with a frequency of 4.67% (21 cases) on all lesions and 13.72% of cancers, Its frequency among the under 40s was 71.42% (15 cases). A male predominance with a sex ratio of 2.16 was noted. The most common site was the ganglion with 9 cases, 42.85%, followed by palatine tonsils and nasosinus cavities, each with 5 cases (23.80%). We also observed it at the level of the tongue and in the cavum with one case each.
• Sarcomas
Sarcomas (Mixoid sarcoma, Osteosarcoma, Angiosarcoma, Kaposi’s sarcoma, Embryonic rhabdomyosarcoma, Liposarcoma) were recorded, 8 cases (1.78% of all lesions and 5.22% of cancers). They were children and adults. The sex ratio is 1.66. The most frequent site was the nasal cavity (4 cases, or 50%) followed by the larynx (2 cases, 25%). We have also observed it in the ganglion and in the temporal region.
Inflammatory pseudo-tumors were represented by 140 cases (31.11%). It was about:
• Specific chronic infections
We noted 27 cases (19.28% of pseudo-tumors and 6% of all ENT lesions). They were represented by 12 cases of tuberculosis (2.66% of all ENT lesions) and 15 cases of Rhinoscleroma (3.33% of all ENT lesions).
• Inflammatory polyps
Represented by 23 cases (16.42% of the pseudo-tumors) of which 19 were in the naso-sinus cavities.
• Non-specific chronic inflammations
Represented by 58 cases or 41.42% of pseudo-tumors. These pseudo-tumors were seen at all ages and a sex ratio of 0.92. We found a predominance of these inflammatory pseudo-tumors in the naso-sinus cavities with 53 cases (41.08%).
We observed three cases distributed respectively between the larynx, the amygdala and at the level of the nasal vestibule. They were all severe and the subjects were men with an age of 6; 50 and 26 years old.
Histological examination is an essential examination in the management of ENT and cervicofacial disorders. In our context of under medicalization access to these examinations is necessary before the excision of all previously undiagnosed conditions. Their gravity in the ENT sphere housing the sense organs, communication and various anatomical structures from the confines of the brain to the thorax [
After the standard examination of haematylene eosin (HE) stained sections, considered a prerequisite for diagnosis, the pathologist often uses complementary techniques: (“HC” Histochemistry, “IHC” Immunohistochemistry, “ME” Electron Microscopy Molecular Biology) [
The distribution of sex is a function of the histological type. This finding is illustrated by data from the literature [
The occurrence of squamous cell carcinoma is poorly distributed in the age groups. We noted its rarity in children (two cases) and a high prevalence in the elderly. The authors reported that the occurrence of carcinomas are rare in the juvenile age, and meet in the fifth and sixth decade of life [
Nasosinus lesions accounted for 47.33% (213 cases) and carcinomas were the most common, as in the Tshisau and Kharoubi series, where carcinomas accounted for 50% - 70% of all primary cancers of the nasal cavity [
Nowadays it is described as a rare tumor and accounts for 0.5% to 4% of benign naso-sinus tumors [
Squamous cell carcinoma accounts for 90% of all laryngeal malignancies [
Laryngeal papillomas are the preserve of children, who can see each other before 10 years of age in two-thirds of cases [
Papillary thyroid carcinoma has the reputation of being the most frequent thyroid cancer as in the work of Bouchair [
The prevalence of parotid benign tumors reaches 60% to 74.5% with the pleomorphic adenoma in mind. Benign tumors were the most common in our study. The parotid is the most important gland of the salivation system. All tumor varieties can be seen at any age and regardless of sex [
The twelve cases of tuberculosis found in our study were distributed unequally. The lymph node involvement was predominant followed by laryngeal and tonsillar involvement. Tuberculosis continues to exist, despite the eradication campaigns, it remains a frequent occurrence in endemic countries [
Histology is a crucial element in the diagnostic process. Expertise is most often needed to confirm the diagnosis of these often rare, and often unrecognized lesions. This precise diagnosis guarantees a suitable treatment.
The authors do not declare any conflict of interest.
Samaké, D., Sidibé, Y., Koné, F.I., Niangaly, H., Diamouténé, K., Konaté, N., Neuilly, N.T.G., Camara, N., Diarra, K., Haidara, A.W., Soumaoro, S., Guindo, B., Singaré, K., Timbo, S.K., Kéïta, M. and Mohamed, A.A. (2019) Histological Profile of ENT and Cervico-Facial Lesions in Mali. International Journal of Otolaryngology and Head & Neck Surgery, 8, 61-69. https://doi.org/10.4236/ijohns.2019.81007