chronic invasive fungal sinusitis

Chronic invasive fungal sinusitis is a form of invasive fungal sinusitis.

Clinical presentation

The condition has a more prolonged course than acute invasive fungal sinusitis, usually more than 12 weeks . Patients are usually immunocompetent or have a milder level of immunocompromise. There may be a history of chronic sinusitis.

Radiographic features

CT

CT usually shows homogeneous opacification of the affected sinus(es), iso- to hyperattenuating to muscle tissue.

Other suggestive features include:

• relative lack of expansion of sinuses
• mottled lucencies or irregular bone destruction may be seen
• bone erosion localized to the area of extrasinus extension
• extrasinus component of the disease more prominent than the intrasinus component
• there may also be sclerotic changes in the bony walls of the affected sinuses representing chronic disease

MRI

Signal characteristics of affected region include:

• T1: iso- or hypointense signal
• T2: usually markedly hypointense signal

Differential diagnosis

• acute invasive fungal sinusitis
  • clinical setting of less than 4 weeks
  • usually does not show hyperdense material within the sinus
  • bony sclerotic changes are uncommon
• chronic granulomatous invasive sinusitis
  • indistinguishable on imaging
• complicated chronic sinusitis
• sinonasal carcinoma
• sinonasal non-Hodgkin lymphoma
• mucocele

Siehe auch:

• Sinunasale Aspergillose
• invasive Aspergillose der Nasennebenhöhlen
• chronisch granulomatöse fungale Sinusitis
• akute invasive fungale Sinusitis

und weiter:

• chronische Sinusitis