Perez-Jaffe L A, Lanza D C, Loevner L A, Kennedy D W, Montone K T
Department of Pathology, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
Laryngoscope. 1997 Feb;107(2):233-40. doi: 10.1097/00005537-199702000-00017.
Allergic fungal sinusitis (AFS) is a serious form of sinonasal fungal disease that is commonly associated with Aspergillus or Dematiaceous fungi. This study was performed to determine the incidence of Aspergillus or Penicillium in AFS by using in situ hybridization (ISH) for Aspergillus and Penicillium ribosomal RNA (rRNA). The Fontana-Masson melanin stain (FMMS) was also used to detect pigmented fungi (A. niger and Dematiaceous fungi). ISH was performed on 26 patients: 17 AFS cases with histologic evidence of fungi, 5 AFS cases without histologic evidence of fungi, 3 cases of invasive fungal sinusitis (IFS), and 1 case of fungus ball. Nine AFS specimens with histologic evidence of fungi were ISH positive. Positivity was also noted in two of three IFS cases, while no staining was seen in the fungus ball and in six AFS specimens without fungi demonstrable by silver stains. Six ISH-positive cases were FMMS positive, suggesting A. niger. Five ISH-negative AFS specimens were FMMS positive, suggesting Dematiaceous fungi. In summary, many AFS patients in our institution demonstrate Aspergillus/Penicillium organisms. Ancillary techniques may help identify fungi responsible for AFS if cultures are negative or not performed. ISH for rRNA is a useful means for rapidly speciating fungi in human tissues.
变应性真菌性鼻窦炎（AFS）是鼻窦真菌病的一种严重形式，通常与曲霉菌或暗色真菌有关。本研究旨在通过对曲霉菌和青霉菌核糖体RNA（rRNA）进行原位杂交（ISH）来确定AFS中曲霉菌或青霉菌的发生率。Fontana-Masson黑色素染色（FMMS）也用于检测色素真菌（黑曲霉和暗色真菌）。对26例患者进行了ISH检测：17例有真菌组织学证据的AFS病例、5例无真菌组织学证据的AFS病例、3例侵袭性真菌性鼻窦炎（IFS）病例和1例真菌球病例。9例有真菌组织学证据的AFS标本ISH呈阳性。在3例IFS病例中的2例也发现了阳性，而在真菌球以及6例经银染未显示真菌的AFS标本中未见到染色。6例ISH阳性病例FMMS呈阳性，提示为黑曲霉。5例ISH阴性的AFS标本FMMS呈阳性，提示为暗色真菌。总之，我们机构的许多AFS患者显示有曲霉菌/青霉菌。如果培养结果为阴性或未进行培养，辅助技术可能有助于识别导致AFS的真菌。rRNA的ISH是在人体组织中快速鉴定真菌种类的一种有用方法。
