目的探讨变应性真菌性鼻窦炎(AFS)的临床病理特征，提高对AFS的认识。方法分析吉林市中心医院2005年7月~2011年7月12例AFS的临床病理及影像学资料，应用过碘酸雪夫(PAS)及环六亚甲基四胺银(GMS)特殊染色标记真菌。结果12例AFS中，男7例，女5例，发病年龄19~46岁。多具有变应性疾病病史。皮肤过敏源试验8例阳性，真菌培养4例阳性。影像学检查示多组鼻窦可见斑片状高密度影，部分病例窦壁骨质可见骨破坏。组织病理学：大体观察送检组织为黏稠的灰褐色果酱样分泌物，镜下表现为“潮汐样”嗜酸性黏液湖，特殊染色于黏液湖中可见真菌菌丝。结论 AFS是一种易被漏诊误诊的疾病，需结合临床及病理学表现综合判定。%Objective To study the clinicopathologic features of allergic fungal sinusitis (AFS) and improve the diagnostic level of AFS. Methods 12 cases of AFS were retrieved from the department archival file of Jinlin central hospital during the period from 2005 to 2011. PAS and GMS stain were carried out using paraffin-embedded tissues. Results The patients included 7 males and 5 females. The age of patients ranged from 19-46 years. Atopy was very common in these patients. Skin antigen tests showed fungal positive (8/12). Fungal cultures were positive for 4 cases. On plain CT scans, the affected nasal sinuses were filled with soft tissue shadow, with patchy hyper density shadow. The bony sinus wall showed pressure erosion. Gross showed sticky putty secretion. Microscopy showed “tide like eosinophilic mucin lake”. Fungal elements were positive stained by special stains. Conclusion AFS is an illness easy to misdiagnose. Accurate diagnosis requires clinical findings and histopathological features.
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