In vivo diagnosis of nasopharyngeal carcinoma using contact rhinoscopy

Objectives: To evaluate the potential use of con. tact endoscopy for the di agnosis of nasopharyngeal carcinoma (NPC). Study Design. Prospective study to examine the nasopharynx of 30 patients with nasopharyngeal carcinoma and 18 subjects with normal nasopharynx in a clinic setting using contact rhin o-scopes (Karl Storz, Tuttlingen, Germany, 7215 AA, 0 degrees and 7215 BA, 30 degrees; 23 cm long, 4 mm. in diameter). Methods. The superficial cells of the normal nasopharynx and the nasopharyngeal tumors were stained with 1 % methylene blue and examined with contact rhinoscopes at high magnificatio ns (x60 and x150). The areas under examination were then biopsied. The cont act endoscopic images were compared with the corresponding hematoxylin and eosin-stained histologic sections of the biopsied tissues. Results: Sixty-s ix procedures were performed in 48 patients. The images of normal pseudostr atified ciliated epithelium and squamous epithelium were readily recognized by contact endoscopy in all subjects with normal nasopharynx (10 men and 8 women; mean age, 51.9 y). Twenty-six of 30 patients with NPC (86.6%;, 18 m en and 8 women; mean age, 50.6 y) were successfully examined by contact end oscopy under local anesthesia. In these 26 patients, two patterns of malign ant cells were identified with contact endoscopy. The patterns of contact e ndoscopic images corresponded well with the histologic findings. Conclusion : Contact endoscopy is an accurate and reliable office-based procedure, whi ch allows for in-vivo diagnosis of nasopharyngeal carcinoma.