Allergic fungal sinusitis

Case contributed by Werner Harmse
Diagnosis almost certain

Presentation

Young adult male with clinical chronic sinusitis.

Patient Data

Age: 35 years
Gender: Male

Unenhanced CT

ct

Opacification with associated expansion, remodelling and erosive changes seen in the right sphenoid sinus. Content within sinus is hyperdense (HU=101, best seen on soft tissue window), with peripheral lower density mucosa. This projects through the sphenoethmoidal recess and into the posterior nasal passage. Hyperdense material represents high density fungal hyphae and findings are consistent with allergic fungal sinusitis.

Sagittal reformat additionally showed multiple small polypoid projections in the right nasal passage consistent with early sinonasal polyposis.

Case Discussion

This case shows CT morphology of allergic fungal sinusitis.

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