Head and Neck Pathology

, Volume 10, Issue 1, pp 40–46 | Cite as

Pathology of Fungal Rhinosinusitis: A Review

Special Issue: Sinonasal Tract Pathology. Guest Editors: Justin Bishop, MD and Alessandro Franchi, MD
First Online:
Received:
Accepted:

Abstract

Fungal rhinosinusitis (FRS) comprises a spectrum of disease processes that vary in clinical presentation, histologic appearances, and biological significance. FRS can be acute or chronic and is most commonly classified as non-invasive or invasive based on whether fungi have invaded into tissue. This manuscript will review the pathologic classification of FRS.

Keywords

Rhinosinusitis Fungal ball Allergic fungal rhinosinusitis Acute invasive fungal rhinosinusitis Aspergillus Allergic mucin 
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References

  1. 1.
    Chakrabarti A, Das A, Panda NK. Controversies surrounding the categorization of fungal sinusitis. Med Mycol. 2009;47(suppl 1):S299–308.CrossRefPubMedGoogle Scholar
  2. 2.
    Chakrabarti A, Denning DW, Ferguson BJ, et al. Fungal rhinosinusitis: a categorization and definitional scheme addressing current controversies. Laryngoscope. 2009;119:1809–18.PubMedCentralCrossRefPubMedGoogle Scholar
  3. 3.
    Granville L, Chirala M, Cernoch P, Ostrowski M, Truong LD. Fungal sinusitis: histologic spectrum and correlation with culture. Hum Pathol. 2004;35:474–81.CrossRefPubMedGoogle Scholar
  4. 4.
    Taxy J. Paranasal fungal sinusitis: contributions of histopathology to diagnosis: a report of 60 cases and literature review. Am J Surg Pathol. 2006;30(6):713–20.CrossRefPubMedGoogle Scholar
  5. 5.
    Das A, Bal A, Chakrabarti A, Panda N, Joshi K. Spectrum of fungal rhinosinusitis; histopathologist’s perspective. Histopathology. 2009;54:854–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Montone KT, Livolsi VA, Feldman MD, Lanza DC, Palmer J, Chiu AG, Kennedy DW, Nachamkin I. Fungal rhinosinusitis: a report of 400 patients at a single university medical center. Int J Otolaryngol. 2012;2012:684835.PubMedCentralPubMedGoogle Scholar
  7. 7.
    Montone K. Recent considerations in the classification and pathogenesis of fungal rhinosinusitis in pathobiology of human disease: a dynamic encyclopedia of disease mechanisms. 2014;1432–44.Google Scholar
  8. 8.
    Dufour X, Kauffman-Lacroix C, Ferrie JC, Goujon JM, Rodier MH, Klossek JM. Paranasal sinus fungal ball epidemiology, clinical features, and diagnosis. A retrospective analysis of 173 cases from a single center in France 1989–2002. Med Mycol. 2006;44:61–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Nicolai P, Lombardi D, Tomenzoli D, Villaret AB, Piccioni M, Mensi M, Maroldi R. Fungus ball of the paranasal sinuses: experience in 160 patients treated with endoscopic surgery. Laryngoscope. 2009;119(11):2275–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Michael RC, Michael JS, Ashbee RH, Mathews MS. Mycological profile of fungal sinusitis: an audit of specimens over a 7-year period in a tertiary care hospital in Tamil Nadu. Indian J Pathol Microbiol. 2008;51:493–6.CrossRefPubMedGoogle Scholar
  11. 11.
    Panda NK, Sharma SC, Chakrabarti A, Mann SBS. Paranasal sinus mycoses in north India. Mycoses. 1998;41:281–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Challa S, Uppin SG, Hanumanthu S, Panigrahi MK, Purohit AK, Sattaluri S, Borgohain R, Chava A, Vemu L, Jagarlapudi MM. Fungal rhinosinusitis: a clinicopathological study from South India. Eur Arch Otorhinolaryngol. 2010;267(8):1239–45.CrossRefPubMedGoogle Scholar
  13. 13.
    Schubert MS. Allergic fungal sinusitis. Otolaryngol Clin N Am. 2004;37:301–26.CrossRefGoogle Scholar
  14. 14.
    Schubert MS. Allergic fungal sinusitis: pathophysiology, diagnosis and management. Med Mycol. 2009;47(suppl 1):S324–30.CrossRefPubMedGoogle Scholar
  15. 15.
    Schubert MS. Allergic fungal sinusitis. Clin Rev Allergy Immunol. 2006;30(3):205–16.CrossRefPubMedGoogle Scholar
  16. 16.
    Laury AM, Wise SK. Allergic fungal rhinosinusitis. Am J Rhinol. 2013;27:S26–7.CrossRefGoogle Scholar
  17. 17.
    Montone K. Role of fungi in the pathophysiology of chronic rhinosinusitis: an update. Curr Allergy Asthma Rep. 2013;13(2):224–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Montone KT. The molecular genetics of inflammatory, autoimmune, and infectious diseases of the sinonasal tract: a review. Arch Pathol Lab Med. 2014;138(6):745–53.CrossRefPubMedGoogle Scholar
  19. 19.
    Lackner A, Stammberger H, Buzina W, et al. Fungi: a normal content of human nasal mucus. Am J Rhinol. 2005;19:125–9.PubMedGoogle Scholar
  20. 20.
    Ponikau JU, Sherris DA, Kern EB, et al. The diagnosis and incidence of allergic fungal sinusitis. Mayo Clin Proc. 1999;74:877–84.CrossRefPubMedGoogle Scholar
  21. 21.
    Ponikau JU, Sherris DA, Weaver A, Kita H. Treatment of chronic rhinosinusitis with intranasal amphotericin B: a randomized, placebo-controlled, double-blind pilot trial. J Allergy Clin Immunol. 2005;115:125–31.CrossRefPubMedGoogle Scholar
  22. 22.
    Ebbens FA, Fokkens WJ. The mold conundrum in chronic rhinosinusitis: where do we stand today? Curr Allergy Asthma Rep. 2008;8(2):93–101.CrossRefPubMedGoogle Scholar
  23. 23.
    Soler ZM, Schlosser RJ. The role of fungi in diseases of the nose and paranasal sinuses. Am J Rhinol Allergy. 2012;26:351–8.PubMedCentralCrossRefPubMedGoogle Scholar
  24. 24.
    Chang C, Gershwin ME, Thompson GR. Fungal diseases of the nose and sinuses: an updated overview. Curr Allergy Asthma Rep. 2013;13:152–61.CrossRefPubMedGoogle Scholar
  25. 25.
    Callejas CA, Doglas G. Fungal rhinosinusitis: what every allergist should know. Clin Exp Allergy. 2013;43:835–49.CrossRefPubMedGoogle Scholar
  26. 26.
    Murr AH, Goldberg AN, Pletcher SD, Dillehay K, Wymer LJ, Vesper SJ. Some chronic rhinosinusitis patients have elevated populations of fungi in their sinuses. Laryngoscope. 2012;122:1438–45.CrossRefPubMedGoogle Scholar
  27. 27.
    Orlandi RR, Marple BF. The role of fungus in chronic rhinosinusitis. Otolaryngol Clin N Am. 2010;43:531–7.CrossRefGoogle Scholar
  28. 28.
    Orlandi RR, Marple BF, Georgelas A, et al. Immunologic response to fungus is not universally associated with rhinosinusitis. Otolaryngol Head Neck Surg. 2009;141(6):750–6.CrossRefPubMedGoogle Scholar
  29. 29.
    Shin SH, Poinikau JU, Sherris DA, et al. Chronic rhinosinusitis: an enhanced immune response to ubiquitous airborne fungi. J Allergy Clin Immunol. 2004;114:1369–75.CrossRefPubMedGoogle Scholar
  30. 30.
    Al-Dousary SH. Allergic fungal sinusitis: radiological and microbiological features of 59 cases. Ann Saudi Med. 2008;28(1):17–21.CrossRefPubMedGoogle Scholar
  31. 31.
    Perez LA, Lanza DC, Loevner LA, Kennedy DW, Montone KT. In situ hybridization for Aspergillus and Penicillium in allergic fungal sinusitis: a rapid means of speciating fungal pathogens in tissues. Laryngoscope. 1997;107(2):233.CrossRefGoogle Scholar
  32. 32.
    Montone KT, Livolsi VA, Lanza DC, Feldman MD, Kennedy DW, Palmer J, Chiu AG, Nachamkin I. Rapid in situ hybridization for dematiaceous fungi using a broad-spectrum oligonucleotide DNA probe. Diagn Mol Pathol. 2011;20(3):180–3.CrossRefPubMedGoogle Scholar
  33. 33.
    Ferguson BJ. Eosinophilic mucin rhinosinusitis: a distinct clinicopathologic entity. Laryngoscope. 2000;110(5):799–813.CrossRefPubMedGoogle Scholar
  34. 34.
    Guo C, Ghaderoshi S, Kephart GM, et al. Improving the detection of fungi in eosinophilic mucin: seeing what we could not see before. Otolaryngol Head Neck Surg. 2012;147(5):943–9.CrossRefPubMedGoogle Scholar
  35. 35.
    Bent JP, Kuhn F. Diagnosis of allergic fungal sinusitis. Otolaryngol Head Neck Surg. 1994;111:580–8.CrossRefPubMedGoogle Scholar
  36. 36.
    Duggal P, Wise SK. Invasive fungal rhinosinusitis. Am J Rhinol Allergy. 2013;27:S28–30.CrossRefPubMedGoogle Scholar
  37. 37.
    Süslü AE, Oğretmenoğlu O, Süslü N, Yücel OT, Onerci TM. Acute invasive fungal rhinosinusitis: our experience with 19 patients. Eur Arch Otorhinolaryngol. 2009;266(1):77–82.CrossRefPubMedGoogle Scholar
  38. 38.
    Monroe MM, McLean M, Sautter N, et al. Invasive fungal rhinosinusitis: a 15 year experience with 29 patients. Laryngoscope. 2013;123:1583–7.CrossRefPubMedGoogle Scholar
  39. 39.
    Taxy JB, El-Zayaty S, Langerman A. Acute fungal sinusitis: natural history and the role of frozen section. Am J Clin Pathol. 2009;132(1):86–93.CrossRefPubMedGoogle Scholar
  40. 40.
    Ghadiali MT, Deckard NA, Farooq U, Astor F, Robinson P, Casiano RR. Frozen-section biopsy analysis for acute invasive fungal rhinosinusitis. Otolaryngol Head Neck Surg. 2007;136(5):714–9.CrossRefPubMedGoogle Scholar
  41. 41.
    Derber C, Elam K, Bearman G. Invasive sinonasal disease due to dematiaceous fungi in immunocompromised individuals: case report and review of the literature. Int J Infect Dis. 2010:e329–32.Google Scholar
  42. 42.
    Campo M, Lewis RE, Kontoyiannis DP. Invasive fusariosis in patients with hematologic malignancies at a cancer center: 1998–2009. J Infect. 2010;60(5):331–7.CrossRefPubMedGoogle Scholar
  43. 43.
    Montone KT, LiVolsi VA, Lanza DC, Kennedy DW, Palmer J, Chiu AG, Feldman MD, Loevner LA, Nachamkin I. In situ hybridization for specific fungal organisms in acute invasive fungal rhinosinusitis. Am J Clin Pathol. 2011;135(2):190–9.CrossRefPubMedGoogle Scholar
  44. 44.
    Montone KT. Differential diagnosis of necrotizing sinonasal diseases. Arch Pathol Lab Med. 2016;139(12):1508–14.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of Pathology and Laboratory MedicineHospital of the University of PennsylvaniaPhiladelphiaUSA

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