Pathologic findings in allergic aspergillus sinusitis. A newly recognized form of sinusitis

The pathologic findings are described in seven cases of allergic aspergillus sinusitis, a newly recognized form of sinusitis. Grossly, the sinuses are filled with firm, white-tan mucoid material. Microscopically this material consists of mucin-containing numerous eosinophils, sloughed respiratory epithelial cells, cellular debris, Charcot-Leyden crystals, and scattered fungal hyphae resembling aspergillus species. This histologic appearance is identical to mucoid impaction occurring in bronchi in allergic bronchopulmonary aspergillosis. Allergic aspergillus sinusitis and allergic bronchopulmonary aspergillosis may represent different manifestations of aspergillus hypersensitivity in the respiratory tract. Implications for treatment of allergic aspergillus sinusitis and a possible relationship between it and allergic bronchopulmonary aspergillosis are discussed.