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Immunohistochemical dissimilarity between allergic fungal and nonfungal chronic rhinosinusitis.
Am J Rhinol Allergy. 2013 May-Jun; 27(3):168-76.AJ

Abstract

BACKGROUNDS

Diagnosis of allergic fungal rhinosinusitis (AFRS) is complicated because of the presence of fungi on mucosal surfaces of sinonasal passages. The objectives of this study were to define, using immunohistochemistry, lymphocyte populations associated with noninvasive fungal-related chronic rhinosinusitis (CRS; AFRS and FBs [FB]) relative to CRS with nasal polyposis (CRSwNP) and CRS without nasal polyposis (CRSsNP) as a means of diagnosing different forms of CRS.

METHODS

Sinus CT scans, nasal endoscopy scores, and the presence of eosinophilic fungal mucin or FBs were used to prospectively define patient groups with CRS who had failed medical treatment and were undergoing endoscopic sinus surgery. Four patient groups were identified: AFRS, FB, CRSwNP, and CRSsNP. Tissue specimens were studied and graded for histopathological changes. Immunophenotyping of mucosal lymphocytes was performed using anti-CD3, -CD20, -CD4, -CD8, -CD56, and -perforin antibodies.

RESULTS

Nasal polyposis scores were similar between AFRS and CRSwNP. Radiological changes associated with AFRS can also be present in CRSwNP, e.g., heterogenicity in 9/30 (30%), expansion in 25/30 (83%), and bony attenuation of the ethmoid trabeculae in 19/30 (63%). Different grades of basement membrane thickness, edema, and fibrosis were observed. In both types of noninvasive fungal rhinosinusitis, CD3+ T lymphocytes were most commonly identified. In cases of AFRS, most T cells were CD8+ (p < 0.001). In FB cases, CD4+ lymphocytes were dominant (p < 0.001). In nonfungal CRS cases, CD20+ lymphocytes (B lymphocytes) predominated (p < 0.001).

CONCLUSION

Although CT scans and histological examination can assist the diagnosis of rhinosinusitis, tissue immunophenotyping can be used in defining different types of fungal and nonfungal CRS cases.

Authors+Show Affiliations

Department of Otorhinolaryngology, Menoufia University Hospital, Shebin El-Kom, Egypt. ahmedragab2000@hotmail.comNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

23710950

Citation

Ragab, Ahmed, and Rehab Monir Samaka. "Immunohistochemical Dissimilarity Between Allergic Fungal and Nonfungal Chronic Rhinosinusitis." American Journal of Rhinology & Allergy, vol. 27, no. 3, 2013, pp. 168-76.
Ragab A, Samaka RM. Immunohistochemical dissimilarity between allergic fungal and nonfungal chronic rhinosinusitis. Am J Rhinol Allergy. 2013;27(3):168-76.
Ragab, A., & Samaka, R. M. (2013). Immunohistochemical dissimilarity between allergic fungal and nonfungal chronic rhinosinusitis. American Journal of Rhinology & Allergy, 27(3), 168-76. https://doi.org/10.2500/ajra.2013.27.3882
Ragab A, Samaka RM. Immunohistochemical Dissimilarity Between Allergic Fungal and Nonfungal Chronic Rhinosinusitis. Am J Rhinol Allergy. 2013;27(3):168-76. PubMed PMID: 23710950.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Immunohistochemical dissimilarity between allergic fungal and nonfungal chronic rhinosinusitis. AU - Ragab,Ahmed, AU - Samaka,Rehab Monir, PY - 2013/5/29/entrez PY - 2013/5/29/pubmed PY - 2014/1/1/medline SP - 168 EP - 76 JF - American journal of rhinology & allergy JO - Am J Rhinol Allergy VL - 27 IS - 3 N2 - BACKGROUNDS: Diagnosis of allergic fungal rhinosinusitis (AFRS) is complicated because of the presence of fungi on mucosal surfaces of sinonasal passages. The objectives of this study were to define, using immunohistochemistry, lymphocyte populations associated with noninvasive fungal-related chronic rhinosinusitis (CRS; AFRS and FBs [FB]) relative to CRS with nasal polyposis (CRSwNP) and CRS without nasal polyposis (CRSsNP) as a means of diagnosing different forms of CRS. METHODS: Sinus CT scans, nasal endoscopy scores, and the presence of eosinophilic fungal mucin or FBs were used to prospectively define patient groups with CRS who had failed medical treatment and were undergoing endoscopic sinus surgery. Four patient groups were identified: AFRS, FB, CRSwNP, and CRSsNP. Tissue specimens were studied and graded for histopathological changes. Immunophenotyping of mucosal lymphocytes was performed using anti-CD3, -CD20, -CD4, -CD8, -CD56, and -perforin antibodies. RESULTS: Nasal polyposis scores were similar between AFRS and CRSwNP. Radiological changes associated with AFRS can also be present in CRSwNP, e.g., heterogenicity in 9/30 (30%), expansion in 25/30 (83%), and bony attenuation of the ethmoid trabeculae in 19/30 (63%). Different grades of basement membrane thickness, edema, and fibrosis were observed. In both types of noninvasive fungal rhinosinusitis, CD3+ T lymphocytes were most commonly identified. In cases of AFRS, most T cells were CD8+ (p < 0.001). In FB cases, CD4+ lymphocytes were dominant (p < 0.001). In nonfungal CRS cases, CD20+ lymphocytes (B lymphocytes) predominated (p < 0.001). CONCLUSION: Although CT scans and histological examination can assist the diagnosis of rhinosinusitis, tissue immunophenotyping can be used in defining different types of fungal and nonfungal CRS cases. SN - 1945-8932 UR - https://www.unboundmedicine.com/medline/citation/23710950/Immunohistochemical_dissimilarity_between_allergic_fungal_and_nonfungal_chronic_rhinosinusitis_ DB - PRIME DP - Unbound Medicine ER -