Demographics:
75 years old, Female
Indication:
Neutropenic fever
Findings
- Complete opacification of the right maxillary sinus which contains high attenuation material. Additional extensive sinus disease compatible with a right ostiomeatal unit pattern
- Several areas of demineralization in the posterior wall of the right maxillary sinus with infiltration of the retroantral fat
- Incidental sialolith in the left submandibular duct, likely a chronic finding given atrophy of the gland
- Ossification of the posterior longitudinal ligament results in moderate spinal canal stenosis at C6-C7
Diagnosis
Invasive fungal sinusitis
Sample Report
Complete opacification of the right maxillary sinus with intermixed high attenuation material, which likely represents inspissated secretions or fungal colonization. Several foci of demineralization of the posterior wall of the right maxillary sinus in conjunction with stranding in the retroantral fat raise concern for an aggressive process such as invasive fungal sinusitis. MRI face with and without contrast could further evaluate extent of disease, particularly if there is concern for intracranial extension.
Discussion