INTRODUCTION
Chronic infectious granulomatous disease of upper respiratory tract (nasal cavity & nasopharynx) characterised by formation of polypoidal masses and warty lesions caused by the sporulating organism Rhinosporidium seeberi.
EPIDEMIOLOGY
Males are more commonly affected than females.
Mode of transmission- water & dust and through injured epithelium of various organs .
LOCALIZATION
Nasalcavity
Palpebral conjuctiva
Middle ear
Nasopharynx
Larynx
Pharynx
CLINICAL FEATURES
GROSS PATHOLOGY
Single/multiple polypoid , pedunculated or sessile masses mimics inflammatory polyp.
CUT SECTION shows pink/purplish , glistening mucoid surface.mature sporangia can be observed as yellow minute dots ,bleeds on touch (as it releases Angiogenesis factor which is the reason for high vascularity ).
Microcysts seen in submucosal stroma.
LIGHT MICROSCOPY
Mucosal & submucosal cysts range from 10-300microns in diameter , found only in connective tissue spaces almost never seen intra cellular.
Sporangia contains innumerable sporangiospores.
Large sporangiospores(5-10um)lies at the centre(small coalesce to form large ).
Small sporangiospores(1-2um) lies at the periphery.
Chronic inflammatory infiltrate include lymphocytes,plasma cells,eosinophils.
Rupture elicits acute inflammatory response but there wont be any GRANULOMA formation.
HISTOCHEMISTRY
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| GOMORRI METHANAMINE SILVER STAIN HIGHLIGHTS SPORANGIA |
Microorganisms –PAS & Mucicarmine positive.
Sudan black , bromophenol blue stains rhinosporidium spores.
DIFFERENTIAL DIAGNOSIS
COCCIDIODOMYCOSIS (C.immitis): R.seeberi larger than C.immitis , wall of R.seeberi stains with Mucin stain.
MYOSPHERULOSIS :GMS stain negative.
SCHNEIDERIAN PAPILLOMA(CYLINDRICAL TYPE):intraepithelial cysts only , R.seeberi both intra & sub mucosal cysts.
MANAGEMENT
DAPSONE 100mg for 6months.
For chronic recurrent lesions –surgery is the option.
Question of the day …what is malignant Rhinosporidiosis??? comment your answers below thank you😀
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