Skip to main content

Advertisement

SpringerLink
Log in

Pathology of Fungal Rhinosinusitis: A Review

  • Special Issue: Sinonasal Tract Pathology. Guest Editors: Justin Bishop, MD and Alessandro Franchi, MD
  • Published:
Head and Neck Pathology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Chakrabarti A, Das A, Panda NK. Controversies surrounding the categorization of fungal sinusitis. Med Mycol. 2009;47(suppl 1):S299–308.

    Article  PubMed  Google Scholar 

  2. Chakrabarti A, Denning DW, Ferguson BJ, et al. Fungal rhinosinusitis: a categorization and definitional scheme addressing current controversies. Laryngoscope. 2009;119:1809–18.

    Article  PubMed Central  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  5. Das A, Bal A, Chakrabarti A, Panda N, Joshi K. Spectrum of fungal rhinosinusitis; histopathologist’s perspective. Histopathology. 2009;54:854–9.

    Article  PubMed  Google Scholar 

  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.

    PubMed Central  PubMed  Google Scholar 

  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.

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  11. Panda NK, Sharma SC, Chakrabarti A, Mann SBS. Paranasal sinus mycoses in north India. Mycoses. 1998;41:281–6.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  13. Schubert MS. Allergic fungal sinusitis. Otolaryngol Clin N Am. 2004;37:301–26.

    Article  Google Scholar 

  14. Schubert MS. Allergic fungal sinusitis: pathophysiology, diagnosis and management. Med Mycol. 2009;47(suppl 1):S324–30.

    Article  CAS  PubMed  Google Scholar 

  15. Schubert MS. Allergic fungal sinusitis. Clin Rev Allergy Immunol. 2006;30(3):205–16.

    Article  PubMed  Google Scholar 

  16. Laury AM, Wise SK. Allergic fungal rhinosinusitis. Am J Rhinol. 2013;27:S26–7.

    Article  Google Scholar 

  17. Montone K. Role of fungi in the pathophysiology of chronic rhinosinusitis: an update. Curr Allergy Asthma Rep. 2013;13(2):224–8.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  19. Lackner A, Stammberger H, Buzina W, et al. Fungi: a normal content of human nasal mucus. Am J Rhinol. 2005;19:125–9.

    PubMed  Google Scholar 

  20. Ponikau JU, Sherris DA, Kern EB, et al. The diagnosis and incidence of allergic fungal sinusitis. Mayo Clin Proc. 1999;74:877–84.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed Central  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  25. Callejas CA, Doglas G. Fungal rhinosinusitis: what every allergist should know. Clin Exp Allergy. 2013;43:835–49.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  27. Orlandi RR, Marple BF. The role of fungus in chronic rhinosinusitis. Otolaryngol Clin N Am. 2010;43:531–7.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  30. Al-Dousary SH. Allergic fungal sinusitis: radiological and microbiological features of 59 cases. Ann Saudi Med. 2008;28(1):17–21.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  33. Ferguson BJ. Eosinophilic mucin rhinosinusitis: a distinct clinicopathologic entity. Laryngoscope. 2000;110(5):799–813.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  35. Bent JP, Kuhn F. Diagnosis of allergic fungal sinusitis. Otolaryngol Head Neck Surg. 1994;111:580–8.

    Article  PubMed  Google Scholar 

  36. Duggal P, Wise SK. Invasive fungal rhinosinusitis. Am J Rhinol Allergy. 2013;27:S28–30.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  38. Monroe MM, McLean M, Sautter N, et al. Invasive fungal rhinosinusitis: a 15 year experience with 29 patients. Laryngoscope. 2013;123:1583–7.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  44. Montone KT. Differential diagnosis of necrotizing sinonasal diseases. Arch Pathol Lab Med. 2016;139(12):1508–14.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, 6 Founders, Philadelphia, PA, 19104, USA

    Kathleen T. Montone

Authors
  1. Kathleen T. Montone
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kathleen T. Montone.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Montone, K.T. Pathology of Fungal Rhinosinusitis: A Review. Head and Neck Pathol 10, 40–46 (2016). https://doi.org/10.1007/s12105-016-0690-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12105-016-0690-0

Keywords

Search

Navigation