摘要
目的探讨变应性真菌性鼻窦炎的CT影像及病理特征.方法分析54例变应性真菌性鼻窦炎患者的CT和病理检查结果 ,同时对其鼻窦分泌物进行真菌培养鉴定.统计本组患者病变数量、骨质侵蚀发生率及真菌培养阳性患者菌种分布情况.结果 CT检查显示病变鼻腔鼻窦透亮度减低,可见条索状、斑片状或云雾状均匀的高密度影,窦壁骨质可有破坏,变薄且不连续.本组患者蝶窦病变数量最多,为97个,筛窦骨质侵蚀发生率最高,为40.4%.病理检查可见成片的无定形嗜酸性或酸碱性的黏液,其内有大量的嗜酸性粒细胞,并可见较多的夏-莱结晶.本组中28例患者鼻分泌物真菌培养阳性,其中曲霉菌属16例,非曲霉菌属12例,菌种分布以烟曲霉(35.7%)、裂褶菌(25.0%)和黄曲霉(21.4%)为主.结论CT检查能清楚显示变应性真菌性鼻窦炎患者的病灶、受累程度及范围,其具有特征性的病理学表现为嗜酸性黏蛋白.
Objective To investigate the CT imaging and pathological features of allergic fungal sinusitis(AFS).Methods The CT and pathological examination results of 54 cases of AFS patients were analyzed,and fungal culture identification of their sinus secretions was conducted.Count the number of lesions,the incidence of bone erosion and the distribution of bacteria in patients with positive fungal culture.Results CT examination showed that the lesions of the sinus and paranasal sinus had a stripe,patchy or cloudlike high density shadow,and the bone wall of the sinus could be destroyed,thin and discontinuous.This group of patients had the largest number of sphenoid sinus lesions,97 cases.The incidence of ethmoid sinus erosion was the highest,which was 40.4%.Pathological examination showed amorphous eosinophilic or acid-base mucus,with large number of eosinophils,more Charcot-Leyden crystallization.28 patients in this group were positive for fungal culture of nasal secretions,including 16 cases of aspergillus and 12 cases of non-aspergillus.The distribution of bacterial species was mainly aspergillus fumigatus(35.7%),schizophyllum(25.0%)and aspergillus flavus(21.4%).Conclusions The CT examination could clearly show the lesion and the extent and scope of involvement of AFS.AFS has a characteristic pathological manifestation of"eosinophilic mucin".
作者
薛世钦
代向党
张亮
王赢
Xue Shiqin;Dai Xiangdang;Zhang Liang;Wang Ying(Central Hospital of Zhumadian,Zhumadian 463000,Henan,China)
出处
《临床心身疾病杂志》
CAS
2020年第4期155-157,共3页
Journal of Clinical Psychosomatic Diseases
