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Cholesterol granuloma and aspergilloma of the maxillary sinus
S Sarioglu1, U Pabuççuoglu, N Arzu Topal
1Dokuz Eylül University, School of Medicine, Department of Pathology Inciralti, Izmir, Turkey. sulen.sarioglu@deu.edu.tr
Abstract:
Cholesterol granuloma (CG) of the paranasal sinuses is rare. The proposed mechanisms of initiation are haemorrhage, impaired drainage and obstruction of ventilation. To the best of our knowledge, association of CG with a specific infection has not been described before. We have recently observed CG and aspergilloma of Aspergillus flavus type from the left maxillary sinus of a 58-year-old male patient presenting with nasal obstruction, headache and postnasal discharge. Any causative relationship between the two findings is obscure. The suspected mechanisms underlying aspergilloma and CG of the paranasal sinuses seems similar, since there is obstruction of ventilation and drainage. The cholesterol accumulation cannot be attributed to cellular components or breakdown products of the aspergillus as the major sterol of the plasma membranes of fungi is ergosterol, not cholesterol.
Insights
Cholesterol granuloma (CG) is a rare sinus condition. This study reports a unique case of CG co-occurring with Aspergillus flavus aspergilloma, suggesting shared risk factors like impaired sinus drainage.
Area of Science:
- Otolaryngology
- Mycology
- Pathology
Background:
- Cholesterol granuloma (CG) of the paranasal sinuses is an uncommon condition.
- Its pathogenesis is typically linked to hemorrhage, impaired drainage, and ventilation obstruction.
- No prior associations between CG and specific sinus infections have been documented.
Observation:
- A rare case of cholesterol granuloma (CG) coexisting with Aspergillus flavus aspergilloma was observed in the left maxillary sinus of a 58-year-old male patient.
- The patient presented with symptoms including nasal obstruction, headache, and postnasal discharge.
- The fungal infection was identified as Aspergillus flavus.
Findings:
- The co-occurrence of CG and aspergilloma in the paranasal sinuses was noted.
- Shared mechanisms, such as ventilation and drainage obstruction, may underlie both conditions.
- Aspergillus flavus was identified as the causative agent of the aspergilloma.
Implications:
- This case highlights a potential, though obscure, relationship between fungal sinus infections and cholesterol granuloma.
- Obstructed sinus ventilation and drainage may be common etiological factors for both CG and aspergilloma.
- Further research is needed to elucidate the precise relationship and potential causative links between fungal infections and CG in the paranasal sinuses.