Criteria for the diagnosis of sinus mycetoma

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Presentation transcript:

Criteria for the diagnosis of sinus mycetoma Richard D. deShazo, MD, Margaret O'Brien, MD, Kimberle Chapin, MD, Maria Soto-Aguilar, MD, Ronnie Swain, MD, Michael Lyons, MD, W.Carter Bryars, MD, Steven Alsip, MD Journal of Allergy and Clinical Immunology Volume 99, Issue 4, Pages 475-485 (April 1997) DOI: 10.1016/S0091-6749(97)70073-3 Copyright © 1997 Mosby, Inc. Terms and Conditions

Figure 1 A, Magnetic resonance image showing homogenous mass in right sphenoid sinus of patient 1 with a small enhancing rim. The mass is adjacent to the right orbital apex. B, Coronal CT of sphenoid sinus of patient 1 with complete opacification of right sphenoid sinus (reversed for conventional presentation). Journal of Allergy and Clinical Immunology 1997 99, 475-485DOI: (10.1016/S0091-6749(97)70073-3) Copyright © 1997 Mosby, Inc. Terms and Conditions

Figure 1 A, Magnetic resonance image showing homogenous mass in right sphenoid sinus of patient 1 with a small enhancing rim. The mass is adjacent to the right orbital apex. B, Coronal CT of sphenoid sinus of patient 1 with complete opacification of right sphenoid sinus (reversed for conventional presentation). Journal of Allergy and Clinical Immunology 1997 99, 475-485DOI: (10.1016/S0091-6749(97)70073-3) Copyright © 1997 Mosby, Inc. Terms and Conditions

Figure 2 Axial CT of sinuses of patient 2 with complete opacification of left maxillary sinus caused by mucoperiosteal thickening. Flocculent calcifications suggest a fungal etiology. Journal of Allergy and Clinical Immunology 1997 99, 475-485DOI: (10.1016/S0091-6749(97)70073-3) Copyright © 1997 Mosby, Inc. Terms and Conditions

Figure 3 Coronal CT of sinus of patient 4 showing opacification of right maxillary and frontal sinuses and right nasal cavity. There is irregular calcification within the nasal mucosa suggesting fungal involvement. Right ethmoid air cells have been resorbed (reversed for conventional presentation). Journal of Allergy and Clinical Immunology 1997 99, 475-485DOI: (10.1016/S0091-6749(97)70073-3) Copyright © 1997 Mosby, Inc. Terms and Conditions

Figure 4 Hematoxylin and eosin stain of histologic section of left maxillary sinus from patient 2 shows a fungus ball and adjacent respiratory epithelium with mild to moderate mononuclear cell infiltrate and edema. (×40) Journal of Allergy and Clinical Immunology 1997 99, 475-485DOI: (10.1016/S0091-6749(97)70073-3) Copyright © 1997 Mosby, Inc. Terms and Conditions

Figure 5 A, Hematoxylin and eosin stain of material from right maxillary sinus of patient 3 showing typical allergic mucin composed of laminated eosinophils, mucus, and cellular debris. Scant hyphae, not shown here, were present in some sections of allergic mucin. (×20) B, Gomori methenamine stain of fungus ball from right maxillary sinus of patient 3 shows dense, matted fungal hyphae with septations. Fungal elements were found immediately adjacent to allergic mucin. (×40) Journal of Allergy and Clinical Immunology 1997 99, 475-485DOI: (10.1016/S0091-6749(97)70073-3) Copyright © 1997 Mosby, Inc. Terms and Conditions

Figure 5 A, Hematoxylin and eosin stain of material from right maxillary sinus of patient 3 showing typical allergic mucin composed of laminated eosinophils, mucus, and cellular debris. Scant hyphae, not shown here, were present in some sections of allergic mucin. (×20) B, Gomori methenamine stain of fungus ball from right maxillary sinus of patient 3 shows dense, matted fungal hyphae with septations. Fungal elements were found immediately adjacent to allergic mucin. (×40) Journal of Allergy and Clinical Immunology 1997 99, 475-485DOI: (10.1016/S0091-6749(97)70073-3) Copyright © 1997 Mosby, Inc. Terms and Conditions