Sinonasal polyposis with secondary fungal infection

Case contributed by Abdel-Rahman Abdel-Halim , 7 Oct 2014
Diagnosis almost certain
Changed by Henry Knipe, 23 Apr 2018

Updates to Case Attributes

Presentation was changed:
Nasal obstruction and headache for a long period.
Body was changed:

Chronic rhinosinusitis is defined as disease lasting more than 12 weeks (1)1.

Fungal infection is relatively common, and is broadly divided into invasive and non-invasive forms,defined, defined by the presence or absence of fungal hyphae in the mucosa and soft tissues of the sinonasal cavity (2)2.

CT characteristically demonstrates multiple sinus opacification with sinus expansion and the presence of hyperdense material. Benign bony remodelling, resorption and erosion into adjacentstructures can be seen (3, 4)3,4.

  • -<p>Chronic rhinosinusitis is defined as disease lasting more than 12 weeks (1).</p><p>Fungal infection is relatively common, and is broadly divided into invasive and non-invasive forms,defined by the presence or absence of fungal hyphae in the mucosa and soft tissues of the sinonasal cavity (2).</p><p>CT characteristically demonstrates multiple sinus opacification with sinus expansion and the presence of hyperdense material. Benign bony remodelling, resorption and erosion into adjacent<br>structures can be seen (3, 4).</p>
  • +<p>Chronic rhinosinusitis is defined as disease lasting more than 12 weeks <sup>1</sup>.</p><p>Fungal infection is relatively common and is broadly divided into invasive and non-invasive forms, defined by the presence or absence of fungal hyphae in the mucosa and soft tissues of the sinonasal cavity <sup>2</sup>.</p><p>CT characteristically demonstrates multiple sinus opacification with sinus expansion and the presence of hyperdense material. Benign bony remodelling, resorption and erosion into adjacent<br>structures can be seen <sup>3,4</sup>.</p>

Updates to Study Attributes

Findings was changed:

Diffuse extensive marked mucosal thickening and almost total soft tissue opacification of the sphenoid and frontal sinuses, both maxillary antra as well as the ethmoidal complexes on both sides, that appears merging with the nasal turbinates and partially obliterating the nasal cavities. 

Soft tissue window images show hyperdensity material within the nasal cavity and both maxillary antra suggesting fungal infection (proved histopathologically).

Note: right temporal arachnoid cyst is seen.

Images Changes:

Image CT (non-contrast) ( update )

Description was removed:
Almost total opacification of paranasal sinuses

Image CT (Soft tissue window) ( update )

Description was removed:
hyperdense material is seen at both maxillary antra and the nasal cavity

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