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What Does "right Side Nasal Polyp And Bilateral Maxillary Sinusitis" Mean?

Posted on Tue, 18 Mar 2014

Question: hi my father has been having discharge of few drops of blood alternate day when he wakes up since last 1 month. he never bleeds during day time. he also has chest pain although there is no cardiac issue. his x ray says "prominent bronchovascular & reticular markings". Also ct scan of NCCT Paranasal sinuses suggest " right side nasal polyp & bilateral maxillary sinusitis. his platelet count is 128000. Doctors have not been able to diagnose, can u please suggest. Is there any other examination required. He is an active smoker.

Answered by Dr. T Shobha Deepak (4 hours later)

Brief Answer: Will require further evaluation Detailed Answer: Hi Welcome to Healthcare-Magic Greetings of the day I do understand your concern and apprehension regarding your father. Even though NCCT (Non contrast Ct scan) has picked up some abnormality like Right side nasal polyp and bilateral Maxillary Sinusitis. These pathology by itself do not cause so much of regular bleeding. To attribute the cause of bleeding to polyp, it will require Functional Endoscopy of the Nose and paranasal sinus to demonstrate actively bleeding site of the polyp and if it's present it can be tackled while doing the endoscopy. If the Endoscopy does not reveal any bleeding point it will require evaluation by Either Contrast CT Scan or Magnetic Resonance Imaging ( MRI) to rule out possibility of Angiodysplasia or Vascular malformations as possible causes in this age group. Also bleeding disorder also has to be considered and ruled out. I would suggest you to discuss these probability with your treating Physician. In case you require any further assistance, will be glad to assist you. Take care Best Regards Dr T Shobha Deepak MBBS, MD

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Shobha Deepak (7 hours later)

What do 'prominent bronchovascular & reticular markings' shown in xray suggest? Is it possible that since my father is a regular smoker for last 30 years, prominent bronchovascular & reticular markings are because of bronchitis and bronchitis is the cause of nose bleed? I want to remind again that he only bleeds in the morning while waking up and that too not on daily basis. Also the quantity of blood is just 8 to 10 drops on a particular morning. Please also tell if we can rule out TB and also can the TB be the cause of this nose bleed. Another question, Is it possible that this kind of nose bleed can be caused by brain heamorrage or something very very serious. Also when we took him to hospital, they did not admit him and according to them it wasn't an emergency.

Answered by Dr. T Shobha Deepak (41 minutes later)

Brief Answer: Not likely to be due to tuberculosis Detailed Answer: Greetings Mr Yaseer Prominent bronchovascular marking are due to chronic smoking. They are less significant findings. Cranial cavity lesion do not produce nasal bleeding, also its very unlikely that tuberculosis will present as bleeding from nose. Tuberculosis presents with Hemoptysis that is bleeding in sputum following coughing. Hypertensive patients can also present with such nasal bleeding. Is his blood pressure normal? I have had many hypertensive patients present only with complaint of nasal bleeding. If you father is having cough then sputum for Acid fast bacilli staining can be done to rule out associated tuberculosis. The nasal bleeding does not appear to be due to tuberculosis or brain problem. Do get back to me if you need any further assistance, will be glad to assist you. Take care Best Regards Dr T Shobha Deepak

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar