Allergic fungal sinusitis (AFS) characteristically shows which finding on CT sinuses?
- A Bony erosion with intracranial extension
- B Air-fluid levels with mucoperiosteal thickening
- C Hyperattenuating material within sinuses and sinus expansion ✓
- D Complete sinus opacification with calcification of the sinus wall
Correct answer: C. Hyperattenuating material within sinuses and sinus expansion
Explanation
The CT hallmark of allergic fungal sinusitis is heterogeneous hyperattenuating material (allergic mucin with fungal hyphae, rich in iron, manganese and calcium) filling and expanding the affected sinuses, often with remodelling and expansion of sinus walls rather than frank erosion. Bony erosion suggests invasive disease. Air-fluid levels are typical of acute bacterial sinusitis. Sinus wall calcification is not a feature of AFS.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
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