Allergic fungal rhinosinusitis (AFRS) is distinguished from chronic rhinosinusitis with polyps by the characteristic CT finding of:

• A Homogeneous soft-tissue opacification of all sinuses
• B Bone erosion through the posterior sinus wall into the cranial fossa
• C Air-fluid levels in multiple sinuses
• D Hyperdense (bright) material within expanded sinuses with peripheral mucosal thickening on CT ✓

Explanation

Allergic fungal rhinosinusitis (AFRS) typically shows pathognomonic CT findings of hyperdense (hyperattenuating) material within expanded sinus cavities, corresponding to inspissated allergic mucin containing fungal hyphae, eosinophils, and Charcot-Leyden crystals. The peripheral rim of mucosal thickening surrounding central hyperdense content is characteristic. Bone remodeling (thinning/expansion) rather than frank erosion is typical. This pattern differs from simple CRS or acute bacterial sinusitis.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.