Why do I have green phlegm and sputum when I clean my nostrils?

Question

Hello doctor,

I am a 30-year-old male, about 154.32 lb. I have been having chronic sinus problems with possible postnasal drip, which was not managed well. I was told that I had GERD four years ago. Lately, I have been having a lot of phlegm and sputum for the last few months when I wake up, which is often green in color. It became my habit to try to clean my nostrils because it feels congested constantly. My doctor has brushed it off, saying it is nothing. I was coping with all of those things above and learned to live with them. I have noticed a yellow lump on my pharynx just behind my uvula that was randomly seen without associating new symptoms. I am not sure if it appeared recently or has been there a while. Also, note that I recently recovered from a heavy chesty cough, so my throat has been slightly irritated. A friend of mine who is a doctor tends to think it can be cobblestone throat, pharyngitis, or reactive lymphoid hyperplasia. But all I can think about is cancer because there is a visible lump there. Please give me your opinion on this. Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thanks for writing in, and I understand your concern. Before explaining about clinical diagnosis in your case, let me assure you that whatever you are seeing over your pharynx is just reactive lymphoid hyperplasia and nowhere related to cancer. Coming to your symptoms, postnasal discharge, nasal obstruction, yellow or green colored discharge coming out of nose usually suggests chronic rhinosinusitis. Postnasal discharge can also occur in reflux disorder. The color of the discharge will be whitish, and there will be other associated reflux symptoms such as burning sensation in the chest, repeated burping, throat irritation, and throat clearing. The technical name for such granulations over the pharynx is granular pharyngitis. It would help if you got a computed tomography (CT) scan of paranasal sinuses and a diagnostic nasal endoscopy for confirmation of diagnosis. Once confirmed, treatment can be planned depending on the severity. Regards.

Answer 2

Hello,

Welcome back to icliniq.com.

It is lymphoid hyperplasia based on your images (attachments removed to protect the patient's identity). A recent upper respiratory tract infection attack would have made it more prominent, but it cannot be the reason for such significant hyperplasia. It will reduce in size eventually as acute inflammation subsides but may not vanish unless underlying irritants like postnasal discharge and reflux laryngopharyngitis. It is not adenoid as they are situated much above this level in the nasopharynx. Even if gets confirmed, chronic rhinosinusitis can usually be treated by medications in more than 50 percent of individuals. The rest of them who do not respond to treatment require functional endoscopic sinus surgery. I hope this helps you. Regards.