Fact-sheet: Non invasive aspergillosis
- Pulmonary aspergilloma
Updated on 07/18/2019 at 11:15 AM
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Definition
Foreign body of fungal origin most commonly forming in the maxillary sinus, but which may also involve the sphenoid sinus and other sinuses.
Benign infectious condition, whose progressive growth may in some cases erode the sinus walls, taking on a "pseudo-tumoral" appearance.
synonym: aspergilloma - noninvasive fungal sinusitis
population:
- immunocompetent, non-atopic adult
- foreign material of dental origin
Clinical features
- unilateral ++
- chronic rhinosinusal dysfunction
- recurrent acute rhinosinusitis
- cacosmia
- sometimes asymptomatic
CT
Maxillary sinusitis plus: complete opacification of the maxillary sinus and ipsilateral nasal cavity
+/- ethmoidal involvement
+/- nasal septum deviation
Spontaneous hyperdensity
Calcification and sometimes metallic density
Thickening and sclerosis of the bony walls
Sometimes diagnosis less obvious -> MRI required
Pseudo-tumoral form with lysis of the bony walls and invasion of adjacent structures
MRI
Sinus filled, hyperintense on T1
Signal void on T2 (magnetic susceptibility artifacts)
No enhancement of the fungal ball
Irregular mucosal enhancement
Management
Surgical treatment:
- removal of the entire fungal ball
- treatment of the causative tooth
Differential diagnosis
That of maxillary sinusitis plus on CT:
- Killian polyp
- Inverted papilloma
- Pyocele