No abstract

We describe a case of allergic fungal sinusitis (AFS) caused by Bipolaris spicifera, the first case reported in Japan. A 70-year-old man was admitted to our hospital because of diplopia following bilateral nasal obstruction and discharge. Radiological studies using computed tomographic scan showed a large soft tissue mass occupying the right frontal, bilateral ethmoid and sphenoid sinuses. He underwent drainage surgery and histopathological examination of the contents of the paranasal sinuses revealed scattered fungal hyphae within "allergic mucin". By cytological examination, these hyphae showed septation at irregular intervals, and were swollen to various sizes. Microbiological studies identified the fungus as Bipolaris spicifera. The presence of allergic mucin and scattered fungal hyphae were very important findings in making a diagnosis of AFS histopathologically, so squash cytology of the contents of the paranasal sinuses was quite useful to observe fungal elements and identify the strain in this case.

To elucidate the effect of fibroblast growth factor on the phenotypical conversion of fibroblasts to mesothelial cells, both immunohistochemical and ultrastructural examinations were carried out on cultured spheroids that were composed of fibroblasts obtained from the parietal pleura of rats with and without addition of antifibroblast growth factor receptor antibody. In the present study, antifibroblast growth factor receptor antibody was employed to block the effect of the autocrine component of fibroblast growth factor in the culture medium. Phenotypical conversion from fibroblast to mesothelial cells was clearly blocked in the experimental group, to which culture medium had been added with antifibroblast growth factor receptor antibody, whereas the control group, cultured without addition of antifibroblast growth factor receptor antibody, showed phenotypical conversion of fibroblasts that was confirmed by the development of macula adherens, microvilli, and positive expression of cytokeratin. These results indicate the possibility that fibroblast growth factor plays a key role in the process of phenotypic conversion of fibroblasts to regenerated mesothelial cells.

The relationship between sinusoidal capillarization and pericellular fibrosis was studied in 29 specimens of human liver from patients with alcoholic liver disease. Immunohistochemically, factor VIII-related antigen was not observed in the normal sinusoidal lining cells, but was localized in the capillaries which proliferated in the pericellular fibrotic region. Fibronectin was localized in the proliferated endoplasmic reticulum of newly formed vascular endothelial cells and hepatocytes with the development of pericellular fibrosis, laminin became apparant in the plasmalemmal vesicles of capillary endothelial cells and pericytes and in the endoplasmic reticulum of mesenchymal cells in Disse's space. From these results, it was revealed that pericellular fibrosis was closely related to sinusoidal capillarization. Furthermore, it is suggested that this sinusoidal capillarization may be caused by neovascularization, and that the extracellular matrix produced by endothelial cells, hepatocytes and mesenchymal cells may promote this process. ACTA PATHOL JPN 38: 615-626, 1988.School 1-1-6, Sendagi, Bunkyo-ku, Tokyo 113, Japan. Alcoholic Liver DiseaseActa Pathol. Jpn.

There have been very few reports in Japan of patients with allergic fungal sinusitis (AFS). We describe two cases caused by Bipolaris spicifera and Schizophyllum commune. The patients were a 70-year-old male (Case 1) and a 55-year-old female (Case 2). Both presented with nasal obstruction and purulent nasal discharge. CT scans revealed each to have a soft tissue mass extending from the ethmoid sinus to the sphenoid sinus. In addition, pathological studies on the contents of the paranasal sinuses of both patients revealed the presence of fungal elements in the allergic mucin. Microbiological studies resulted in the recovery of Bipolaris spicifera from Case 1 and Schizophyllum commune from Case 2. To date there have been no reports of AFS due to these two fungi in Japan. It is very important in the diagnosis of AFS to demonstrate the presence of fungal elements in the allergic mucin. Squash cytology of the paranasal sinus contents was especially useful for proving the presence of fungi.