摘要
目的:分析毛霉菌性鼻窦炎临床和组织病理学特点,探讨其诊断和鉴别诊断。方法:对1例双侧上颌窦、右侧蝶窦毛霉菌感染病例的临床表现、组织形态、组织化学染色特点及治疗和预后等进行观察并复习文献。结果:CT示双侧上颌窦、右侧蝶窦粘膜增厚并见软组织样密度影,骨质未见破坏,术中鼻窦内见黑色坏死物。术后病理证实为毛霉菌性鼻窦炎,其特点是在坏死组织中除见大量毛霉菌菌丝和孢子外,尚观察到极为罕见、酷似菊花团样的孢子囊。结论:毛霉菌感染是真菌性鼻窦炎较少见的机会性致病菌,确诊主要依据组织病理学检查,鼻窦清创术加全身广谱抗真菌药物治疗有效,但有潜在侵袭性,故应密切随访。
Objective ：To investigate the clinical and pathological features of mueoraceous rhinosinusitis for diagnosis and differential diagnosis. Methods ： One case of bilateral maxillary sinus and right sphenoid rhinosinusitis of mucorales with sporangia was reported with review of the literatures by analyzing the the clinical and morphological presentation, characteristics of histochemical staining, therapy and prognosis in this disease. Results：A 46-year- old female was admitted with the complaint of right rhinogenous headache. Bilateral maxillary and right sphenoid sinus were manifested as benign mucosal thickening and soft tissue mass on computed tomography, but with absence of bone destrucion. The diseased sinus were filled with black necrotic tissue in surgical findings. Post-operatively,the disease was pathologically confirmed mucoraceous rhinosinusitis, characterized by many hyphae and spores, especially by rare typical sporangia like chrysanthemum in necrotic tissues. Conclusions： Mucorales are rare opportunistic fungal infections, but diagnosis chiefly relies on histopathologic examination. The effective treatment should include the debridement of sinus and systemic anti-fungal drug. Frequent follow-up is recommended ,for the mucorales have the potential ability of invasion.
出处
《皖南医学院学报》
CAS
2009年第6期424-427,共4页
Journal of Wannan Medical College
关键词
毛霉菌
孢子囊
鼻窦炎
形态学
病理学
mucorales
sporangia
rhinosinusitis
morphology
pathology
