Nasal discharge cytology an important diagnostic method for allergic fungal sinusitis: report of three cases.
Allergic fungal sinusitis (AFS) is a distinct clinicopathological entity. It occurs in immunocompetent individuals with history of atopy, increased IgE levels and peripheral eosinophilia and causes noninvasive pansinusitis. It is histologically characterised by the presence of 'allergic mucin' with clusters of eosinophils, charcot - Leyden crystals and scattered fungal hyphae. AFS is an immunological reaction to fungal deposits. As AFS is noninvasive, fungal hyphae can be demonstrated in nasal secretions on cytology. Etiological agent of AFS is Aspergillus or pigmented dematiaceous family. Special stains are helpful for identification. We came across three cases of age group ranging from 26 to 60-year of recurrent rhinitis with nasal discharge. The nasal secretions were collected by nasal swabs onto the glass slide and stained with Giemsa and silver stains. Smears revealed fungal hyphae amidst inflammatory cells with occasional Charcot-Leyden crystals. Nasal secretion cytology plays an important role in diagnosis and can be used for preoperative as well as intraoperative diagnosis of AFS and can be used as an additional diagnostic tool.
Associate Professor, FICP, Department of Pathology, Byramjee Jeejeebhoy Government Medical College , Pune, India .
Sharada Raju
SR
Rane
Assistant Professor, Department of Pathology, Byramjee Jeejeebhoy Government Medical College , Pune, India .
Nalini Vinayak
NV
Kadgi
Ex-Student, Department of Pathology, Byramjee Jeejeebhoy Government Medical College , Pune, India .
Sonal Ashok
SA
Agrawal
Associate Professor, Department of Pathology, Byramjee Jeejeebhoy Government Medical College , Pune, India .
Anita Neelkanth
AN
Kavatkar
Allergic mucin; Charcot – Leyden crystals; Fungal hyphae