Aspergillosis of the paranasal sinuses x-ray diagnosis, histopathology, and clinical aspects.

Aspergillosis is not a rare disease of the paranasal sinuses; more than 80 cases were reported from 1976 to 1982 in the University ENT Clinic at Graz, Austria. Of 59 patients studied, 27 presented almost metal-dense x-ray shadows resembling foreign bodies in one of the sinuses. By means of light and electron microscopic investigations as well as x-ray fluorescence analysis, it can be demonstrated that these areas are equivalent to local enrichment of calcium phosphate in the center of the noninvasive fungal masses in the sinuses. A detailed description of the histopathology of Aspergillus fumigatus is given. For clinical diagnosis, the detection of almost metal-dense x-ray shadows in the absence of foreign-body history in our experience may be regarded as almost certain for aspergillosis of the paranasal sinuses.