Clinicopathologic and immunohistochemical characteristics of fungal sinusitis

Cheng Hsiang Hsiao, Shu Ying Li, Jiun-Ling Wang, Chia Ming Liu

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

Background and Purpose: Fungal sinusitis (FS) is a common disease in Taiwan. Histologically, there are 4 types of FS, i.e., acute invasive, chronic invasive, fungal ball and allergic FS. Among the various fungal pathogens, Aspergillus is the most important. This study analyzed results of antibody staining against Aspergillus species on tissue sections of FS to identify fungal elements and evaluated the role of Aspergillus in different types of FS. Methods: We retrospectively reviewed 140 cases with a pathologic diagnosis of FS in our hospital from 1995 to 2003. The clinical information, hematoxylin and eosin staining, and Gomori methenamine silver staining results for each patient were analyzed. Patients were reclassified into 4 categories of FS according to histologic presentation. The causative fungi were divided into Aspergillus and non-Aspergillus groups according to the results of immunoreactivity against anti-Aspergillus antibody. Results: Fungal ball was diagnosed in 126 patients (90%), 66.6% of whom were females. Only 3 patients died of underlying disease not related to the fungal infection. Immunohistochemical staining demonstrated Aspergillus infection in 108 out of 119 patients (90.7%). Thirteen patients were categorized as having acute invasive FS due to the presence of vascular and stromal invasion. All but 1 patient had underlying diseases associated with immunocompromised status and 11 out of the 13 patients died of sepsis. Immunohistochemical study revealed 5 of these patients were infected with Aspergillus species, and the other 8 were infected with non-Aspergillus fungi. Allergic FS was diagnosed in 1 patient based on the presence of allergic mucin containing numerous eosinophils and few fungal hyphae. The fungal elements were negative for anti-Aspergillus antibody. None of the patients had chronic invasive FS. Conclusion: Fungal ball and acute invasive FS were the 2 most common types of FS in this study from Taiwan. However, both allergic FS and chronic invasive FS are rare. Immunohistochemical staining was useful in identifying specific species of fungus in tissue sections. Aspergillus accounted for 90.7% of fungal ball infections and 38.4% of acute invasive FS infections. It is important to differentiate among the categories of FS because the clinical course, etiology, treatment and prognosis are quite different.

Original languageEnglish
Pages (from-to)549-556
Number of pages8
JournalJournal of the Formosan Medical Association
Volume104
Issue number8
Publication statusPublished - 2005 Dec 1

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Sinusitis
Aspergillus
Staining and Labeling
Fungi
Mycoses
Taiwan
Anti-Idiotypic Antibodies
Methenamine
Silver Staining
Hyphae
Mucins
Hematoxylin
Eosine Yellowish-(YS)
Eosinophils

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Hsiao, Cheng Hsiang ; Li, Shu Ying ; Wang, Jiun-Ling ; Liu, Chia Ming. / Clinicopathologic and immunohistochemical characteristics of fungal sinusitis. In: Journal of the Formosan Medical Association. 2005 ; Vol. 104, No. 8. pp. 549-556.
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title = "Clinicopathologic and immunohistochemical characteristics of fungal sinusitis",
abstract = "Background and Purpose: Fungal sinusitis (FS) is a common disease in Taiwan. Histologically, there are 4 types of FS, i.e., acute invasive, chronic invasive, fungal ball and allergic FS. Among the various fungal pathogens, Aspergillus is the most important. This study analyzed results of antibody staining against Aspergillus species on tissue sections of FS to identify fungal elements and evaluated the role of Aspergillus in different types of FS. Methods: We retrospectively reviewed 140 cases with a pathologic diagnosis of FS in our hospital from 1995 to 2003. The clinical information, hematoxylin and eosin staining, and Gomori methenamine silver staining results for each patient were analyzed. Patients were reclassified into 4 categories of FS according to histologic presentation. The causative fungi were divided into Aspergillus and non-Aspergillus groups according to the results of immunoreactivity against anti-Aspergillus antibody. Results: Fungal ball was diagnosed in 126 patients (90{\%}), 66.6{\%} of whom were females. Only 3 patients died of underlying disease not related to the fungal infection. Immunohistochemical staining demonstrated Aspergillus infection in 108 out of 119 patients (90.7{\%}). Thirteen patients were categorized as having acute invasive FS due to the presence of vascular and stromal invasion. All but 1 patient had underlying diseases associated with immunocompromised status and 11 out of the 13 patients died of sepsis. Immunohistochemical study revealed 5 of these patients were infected with Aspergillus species, and the other 8 were infected with non-Aspergillus fungi. Allergic FS was diagnosed in 1 patient based on the presence of allergic mucin containing numerous eosinophils and few fungal hyphae. The fungal elements were negative for anti-Aspergillus antibody. None of the patients had chronic invasive FS. Conclusion: Fungal ball and acute invasive FS were the 2 most common types of FS in this study from Taiwan. However, both allergic FS and chronic invasive FS are rare. Immunohistochemical staining was useful in identifying specific species of fungus in tissue sections. Aspergillus accounted for 90.7{\%} of fungal ball infections and 38.4{\%} of acute invasive FS infections. It is important to differentiate among the categories of FS because the clinical course, etiology, treatment and prognosis are quite different.",
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Clinicopathologic and immunohistochemical characteristics of fungal sinusitis. / Hsiao, Cheng Hsiang; Li, Shu Ying; Wang, Jiun-Ling; Liu, Chia Ming.

In: Journal of the Formosan Medical Association, Vol. 104, No. 8, 01.12.2005, p. 549-556.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Clinicopathologic and immunohistochemical characteristics of fungal sinusitis

AU - Hsiao, Cheng Hsiang

AU - Li, Shu Ying

AU - Wang, Jiun-Ling

AU - Liu, Chia Ming

PY - 2005/12/1

Y1 - 2005/12/1

N2 - Background and Purpose: Fungal sinusitis (FS) is a common disease in Taiwan. Histologically, there are 4 types of FS, i.e., acute invasive, chronic invasive, fungal ball and allergic FS. Among the various fungal pathogens, Aspergillus is the most important. This study analyzed results of antibody staining against Aspergillus species on tissue sections of FS to identify fungal elements and evaluated the role of Aspergillus in different types of FS. Methods: We retrospectively reviewed 140 cases with a pathologic diagnosis of FS in our hospital from 1995 to 2003. The clinical information, hematoxylin and eosin staining, and Gomori methenamine silver staining results for each patient were analyzed. Patients were reclassified into 4 categories of FS according to histologic presentation. The causative fungi were divided into Aspergillus and non-Aspergillus groups according to the results of immunoreactivity against anti-Aspergillus antibody. Results: Fungal ball was diagnosed in 126 patients (90%), 66.6% of whom were females. Only 3 patients died of underlying disease not related to the fungal infection. Immunohistochemical staining demonstrated Aspergillus infection in 108 out of 119 patients (90.7%). Thirteen patients were categorized as having acute invasive FS due to the presence of vascular and stromal invasion. All but 1 patient had underlying diseases associated with immunocompromised status and 11 out of the 13 patients died of sepsis. Immunohistochemical study revealed 5 of these patients were infected with Aspergillus species, and the other 8 were infected with non-Aspergillus fungi. Allergic FS was diagnosed in 1 patient based on the presence of allergic mucin containing numerous eosinophils and few fungal hyphae. The fungal elements were negative for anti-Aspergillus antibody. None of the patients had chronic invasive FS. Conclusion: Fungal ball and acute invasive FS were the 2 most common types of FS in this study from Taiwan. However, both allergic FS and chronic invasive FS are rare. Immunohistochemical staining was useful in identifying specific species of fungus in tissue sections. Aspergillus accounted for 90.7% of fungal ball infections and 38.4% of acute invasive FS infections. It is important to differentiate among the categories of FS because the clinical course, etiology, treatment and prognosis are quite different.

AB - Background and Purpose: Fungal sinusitis (FS) is a common disease in Taiwan. Histologically, there are 4 types of FS, i.e., acute invasive, chronic invasive, fungal ball and allergic FS. Among the various fungal pathogens, Aspergillus is the most important. This study analyzed results of antibody staining against Aspergillus species on tissue sections of FS to identify fungal elements and evaluated the role of Aspergillus in different types of FS. Methods: We retrospectively reviewed 140 cases with a pathologic diagnosis of FS in our hospital from 1995 to 2003. The clinical information, hematoxylin and eosin staining, and Gomori methenamine silver staining results for each patient were analyzed. Patients were reclassified into 4 categories of FS according to histologic presentation. The causative fungi were divided into Aspergillus and non-Aspergillus groups according to the results of immunoreactivity against anti-Aspergillus antibody. Results: Fungal ball was diagnosed in 126 patients (90%), 66.6% of whom were females. Only 3 patients died of underlying disease not related to the fungal infection. Immunohistochemical staining demonstrated Aspergillus infection in 108 out of 119 patients (90.7%). Thirteen patients were categorized as having acute invasive FS due to the presence of vascular and stromal invasion. All but 1 patient had underlying diseases associated with immunocompromised status and 11 out of the 13 patients died of sepsis. Immunohistochemical study revealed 5 of these patients were infected with Aspergillus species, and the other 8 were infected with non-Aspergillus fungi. Allergic FS was diagnosed in 1 patient based on the presence of allergic mucin containing numerous eosinophils and few fungal hyphae. The fungal elements were negative for anti-Aspergillus antibody. None of the patients had chronic invasive FS. Conclusion: Fungal ball and acute invasive FS were the 2 most common types of FS in this study from Taiwan. However, both allergic FS and chronic invasive FS are rare. Immunohistochemical staining was useful in identifying specific species of fungus in tissue sections. Aspergillus accounted for 90.7% of fungal ball infections and 38.4% of acute invasive FS infections. It is important to differentiate among the categories of FS because the clinical course, etiology, treatment and prognosis are quite different.

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