Nose - Hyperplasia, Goblet Cell
comment:Goblet (mucous) cell hyperplasia ( Figure 1 , Figure 2 , Figure 3 , Figure 4 , and Figure 5 ) is seen after exposure to some irritants and may be the only change noted in response to short-term exposure to a mild irritant. It is most often seen in areas of the nasal cavity that are lined by transitional and respiratory epithelium (levels I and II). The respiratory epithelium normally contains a few goblet cells; the term "metaplasia" may be more correct when the lesion is present in the transitional epithelium (which normally lacks goblet cells). However, to maintain consistency, the NTP prefers the term "hyperplasia" for this lesion, regardless of the epithelial type. The lesion is characterized by the presence of (in transitional epithelium) or increase in the number of (in respiratory epithelium) goblet cells in the epithelial lining. The goblet cells may form intraepithelial glands, or they may coalesce to form mucous cysts ( Figure 5 , arrow). Goblet cell hyperplasia has been seen in both short- and long-term studies. It is thought to be an adaptive response to irritant exposure and is not considered a preneoplastic change.
recommendation:Goblet cell hyperplasia should be diagnosed whenever it is present and assigned a severity grade. The type of epithelium affected should be indicated in the diagnosis by a site modifier (e.g., respiratory epithelium or transitional epithelium). The goblet cells may be enlarged or hypertrophied, but goblet cell hypertrophy should not be concurrently diagnosed; rather, the hypertrophy should be described in the pathology narrative. Associated lesions, such as inflammation or epithelial hyperplasia, should be diagnosed separately.
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