PMC4900106_01
39-year-old female with refractory AML in blast crisis presented with nasal drainage unresponsive to antibiotic treatment. (A) Noncontrast sinus CT demonstrates an opacified right-nasal-cavity and subtle right-orofacial soft-tissue infiltration (arrow) with adjacent nasal-cavity mucosal edema. (B) Noncontrast facial CT performed for trauma two weeks earlier demonstrates a hematoma (arrow), but normal orofacial soft tissue. (C) T2-weighted and (D) T1-weighted post-gadolinium, fat-saturated MRI performed on Day 2 demonstrates progression, with worsening orofacial soft-tissue infiltration and nonenhancing nasal cavity mucosa (arrows).
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AML in blast crisis and an absolute neutrophil count under 500 cells/microliter presented with nasal drainage that was unresponsive to antibiotic treatment. A CT scan showed a new right-nasal-cavity mucosal edema with subtle orofacial soft-tissue infiltration (Fig. 1A), compared to CT performed two weeks earlier for unrelated facial trauma (Fig. 1B). MRI performed the following day demonstrated further orofacial soft-tissue infiltration and nonenhancing right-nasal-cavity mucosa (Figs. 1C, D).
PMC4900106_02
15-year-old male with hemophagocytic lymphohistiocytosis developed neutropenic fever and facial swelling following induction chemotherapy. (A) Noncontrast sinus CT and (B) T1-weighted MRI demonstrate right orofacial soft-tissue infiltration without sinonasal disease (arrow).
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CT and MRI showed minimal orofacial soft-tissue infiltration without paranasal sinus, nasal cavity, or bone erosion (Figs 2A, B). Repeated MRI confirmed these findings with worsening orofacial soft-tissue infiltration and new maxillary sinus mucosal edema (Figs. 2C, D).