Appearances of paranasal fungal sinusitis on computed tomography

The primary invasive granulomatous form of fungal sinusitis, due to inhalation of aspergillus spores, is commonest in the Sudan and the Gulf states. This condition often presents clinically as a chronic, severe sinusitis which has not responded to antibiotics. On CT scanning, the major feature is a soft tissue mass, which is either homogeneous or has lower attenuation components. There may be erosion or expansion of the bony margins of the sinuses. Intraorbital and/or intracranial extension sometimes occur.