Pathologic Features of Non-Invasive Fungal Rhinosinusitis

The purposes of this study were to quanititate and correlate the findings of pathologic specimens and fungal culture in patients with a diagnosis of allergic fungal rhinosinusitis. Seventeen patients were identified between 2003 and 2005 with noninvasive fungal rhinosinusitis. Surgical specimens were analyzed via routine and special pathologic processing and compared to the microbiological results of fungal cultures of these same surgical specimens. Eleven patients (65%) had a positive fungal culture, and 10 patients (59%) had a positive fungal stain. The most characteristic pathologic feature was the presence of allergic fungal mucin. This consisted of inspissated basophilic mucin with alternating areas of large numbers of eosinophils. There is a broad spectrum of pathologic changes found in specimens suspected of Eosinophilic fungal rhinosinusitis. Fungal cultures do not always correspond to these pathologic changes. A high index of suspicion is necessary to make this diagnosis and provide adequate treatment.