title: [Two cases of allergic fungal rhinosinusitis with bone destruction].
abstract: We report herein two cases of allergic fungal rhinosinusitis accompanied by bone destruction of the adjacent nasal sinuses. The first case involved a 21-year-old man who presented with left exophthalmos. Computed tomography (CT) showed soft tissue lesions in the left paranasal sinuses and destruction of the left lamina papyraceae, as well as infiltration of the lesion into the orbit. In the second case, a 39-year-old man, CT showed bone destruction of the skull base and medial wall of the left orbit. In both cases, total serum immunoglobulin (Ig)E level was >1000 IU/mL and fungus-specific IgEs were increased. Fungal hyphae were identified within the mucus on histopathological examination in both cases; however, no fungal invasion of the mucosa was apparent. Final diagnosis was allergic fungal rhinosinusitis (AFRS) in both cases. AFRS is a relatively new disease concept that was proposed in the early 1980s, with disease characteristics very similar to eosinophilic rhinosinusitis. Occasionally, AFRS must be differentiated from malignant disease or invasive fungal rhinosinusitis, so an understanding of the clinical features is important.
authors.affiliation: Department of Otorhinolaryngology, Saitama Medical University; Allergy Center, Saitama Medical University.
authors.forename: Tomoe
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Department of Otorhinolaryngology, Saitama Medical University; Allergy Center, Saitama Medical University.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kamijo
authors.affiliation: Department of Otorhinolaryngology, Saitama Medical University.
authors.forename: Masami
authors.initials: M
authors.lastname: Nakajima
authors.affiliation: Department of Otorhinolaryngology, Saitama Medical University.
authors.forename: Han
authors.initials: H
authors.lastname: Matsuda
authors.affiliation: Department of Head and Neck Surgery, Saitama Medical University International Medical Center.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Inoue
authors.affiliation: Department of Head and Neck Surgery, Saitama Medical University International Medical Center.
authors.forename: Masashi
authors.initials: M
authors.lastname: Sugasawa
authors.affiliation: Department of Otorhinolaryngology, Saitama Medical University; Allergy Center, Saitama Medical University.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Kase
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D009181:Mycoses; D009915:Orbit / Q000382:microbiology / Q000473:pathology; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology*; D065631:Rhinitis, Allergic; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology* / Q000628:therapy; D012852:Sinusitis / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology* / Q000628:therapy; D019291:Skull Base / Q000382:microbiology / Q000473:pathology; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007073:Immunoglobulin E