Comparison of Inflammatory Cells Infiltrating the Maxillary Sinus Mucosa between Chronic Sinusitis and Noninvasive Fungal Sinusitis

Yun, Du Hwan; Chung, Yoo Sam; Lee, Bong Jae

Abstract

BACKGROUND: Fungal sinusitis (mycetoma)is distinguished from chronic sinusitis in the aspect of unilateral maxillary sinus involvement. We aimed to elucidate the mechanism of localization in fungal sinusitis by comparing the inflammatory cells infiltrating into the mucosa. MATERIALS AND METHOD: Study subjects were 10 patients with chronic sinusitis involving the maxillary sinus and 10 patients with fungal sinusitis (mycetoma of the maxillary sinus). Pathological mucosa of the maxillary sinus near the ostium were obtained during endoscopic sinus surgery. We counted the number of basophils, eosinophils, neutrophils, plasma cells, and lymphocytes within 1 mm2 (2 mmX0.5 mm)of the central, superficial area of the lamina propria of the pathological mucosa, under a light microscope (X400)using eye reticule.
RESULTS
The average numbers of basophils, eosinophils, neutrophils, plasma cells, lymphocytes, and the total inflammatory cells in chronic sinusitis were 7, 50, 71, 231, 647, and 1,008, respectively: and in fungal sinusitis, the numbers were 5, 36, 18, 444, 676, and 1,180. In chronic sinusitis, neutrophils were significantly increased when compared to those of fungal sinusitis patients. In fungal sinusitis, infiltration of plasma cells was significantly increased when compared to that of chronic sinusitis. And for both groups, plasma cells and lymphocytes were the two most predominant inflammatory cells.
CONCLUSION
The increased plasma cells in non-invasive fungal sinusitis could be the mechanism for the localization of the fungal lesion within the maxillary sinus, possibly by producing immunoglobulin against fungi.