Tamura Koichi, Takeda Kazuya, Tsuda Takeshi, Kawai Makiko, Inohara Hidenori
Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, JPN.
Department of Pathology, Osaka University Graduate School of Medicine, Suita, JPN.
Cureus. 2024 Jul 26;16(7):e65414. doi: 10.7759/cureus.65414. eCollection 2024 Jul.
Granulomatous lesions in the nasal sinuses are associated with a variety of diseases, including immune disorders such as sarcoidosis, vasculitis, immunoglobulin G4 (IgG4)-related diseases, malignant lymphomas, and microbial infections. Here, we report a rare case of fungal granuloma that occurred exclusively within the nasal septum. The patient presented to the Department of Surgery with the chief complaint of nasal obstruction associated with nasal septal deviation. A bulge was found below the right nasal septum. Initially, it was diagnosed as mucosal swelling associated with rhinitis, and surgery was performed. A granulomatous lesion with bone destruction was found under the mucosa of the nasal septum, which led to the diagnosis of fungal granulation based on postoperative pathology. Though bacterial and fungal infections of the nasal septum are occasionally observed, this is the first reported instance of a fungal granuloma confined to the nasal septum. Infection within the nasal septum, although rare, should also be considered as a differential diagnosis for morphological abnormalities of the nasal septum.
鼻窦中的肉芽肿性病变与多种疾病相关，包括免疫紊乱，如结节病、血管炎、免疫球蛋白G4（IgG4）相关疾病、恶性淋巴瘤以及微生物感染。在此，我们报告一例罕见的仅发生于鼻中隔内的真菌性肉芽肿病例。该患者因鼻中隔偏曲伴鼻塞为主诉就诊于外科。在右侧鼻中隔下方发现一个隆起。最初，诊断为与鼻炎相关的黏膜肿胀，并进行了手术。在鼻中隔黏膜下发现了一个伴有骨质破坏的肉芽肿性病变，术后病理诊断为真菌性肉芽。虽然鼻中隔的细菌和真菌感染偶尔可见，但这是首例局限于鼻中隔的真菌性肉芽肿报道。鼻中隔内的感染虽然罕见，但也应作为鼻中隔形态异常的鉴别诊断之一。
