Nasal polyposis in Peutz-Jeghers syndrome: A distinct histopathological and molecular genetic entity

Wendy W.J. De Leng, Anne Marie Westerman, Marian A.J. Weterman, Marnix Jansen, Herman Van Dekken, Francis M. Giardiello, Felix W.M. De Rooij, J. H.Paul Wilson, G. Johan A. Offerhaus, Josbert J. Keller

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Peutz-Jeghers syndrome (PJS) is an autosomal dominant hamartomatous polyposis syndrome of the gastrointestinal tract, caused by a germline STK11/LKB1 mutation. Nasal polyposis was described in the original report by Peutz. Recently, a molecular-genetic association between nasal polyposis and PJS has been reported. Objective: To further explore the occurrence and pathogenesis of PJS-related nasal polyposis. Methods: 51 patients with PJS, 84 unaffected family members and 36 spouses from 18 families with PJS were questioned for the presence of nasal polyposis. 12 PJS-related nasal polyps, 1 carcinoma of the nasal cavity and 28 sporadic nasal polyps were analysed for loss of (wild type) STK11/LKB1, eosinophilia, squamous metaplasia, dysplasia and expression of cyclo-oxygenase 2 and p53. Results: Nasal polyps occurred in 8 of 51 patients with PJS, and were not reported by non-affected family members (p<0.001). Germline STK11/LKB1 mutations were identified in all patients with PJS and nasal polyposis. Loss of heterozygosity was found in four of eight PJS-related nasal polyps, but not in sporadic nasal polyps (p = 0.002). PJS-related nasal polyps showed less eosinophilic than sporadic nasal polyps (p<0.001). Expression of cyclo-oxygenase 2 was found in 11 of 12 PJS-related nasal polyps and 19 of 28 sporadic nasal polyps (p>0.05). Overexpression of p53 was not found. Conclusions: Nasal polyposis occurs in a significant number of Dutch patients with PJS, one of whom developed a carcinoma in the nasal cavity. The loss of heterozygosity, and the absence of eosinophilia suggest a distinct pathogenesis compared with sporadic nasal polyposis.

Original languageEnglish (US)
Pages (from-to)392-396
Number of pages5
JournalJournal of clinical pathology
Volume60
Issue number4
DOIs
StatePublished - Apr 2007

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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