PMC4058497_01
Base (axial plane) CT image shows the presence of a soft tissue density mass in the right sphenoid sinus, occluding the sinus lumen and the spheno-ethmoid osteum also osteostructural alterations, mainly lytic, of the lateral sinus wall and in part of the large sphenoid wing (a); base (coronal plane) CT image with MIP (maximum intensity project) reconstruction shows lytic osteostructural alteration of the right side of the hard palate, with interruption of the cortical contour and, in part, of the alveolar process of the jaw in the first sextant (b); axial T1-weighted MRI image after mdc administration shows meningeal enhancement in the right temporal lobe. Also enhancement of the temporiun on the right side and the Sylvian aqueduct indicating transcompartment fungal infection involvement (c); coronal T1-weighted MRI image after administration of mdc shows a large amount of phlogistic tissue, intensely and homogenously enhanced after mdc, which fills the Meckel's cavity and engulfs the intracavernous branches of the internal carotid artery in the absence of perceptible ischaemic lesions of the brain parenchyma (d).
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fig1
Spores and broad, stubby, irregularly-shaped hyphae, in many cases with nondichotomous right-angle branching; (a) hematoxylin-eosin staining, (b) PAS staining, and (c)-(d) Gomori silver methenamine staining; original magnification = 400x.
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fig2
They were more evident by hematoxylin-eosin staining (H-E) Figure 2(a) than by PAS Figure 2(b). Gomori silver methenamine (GMS) staining was also positive (Figures 2(c) and 2(d)).
Patient on admission (a) and after treatment (b).
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fig3