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Letters to the Editor
October 1999

Diagnosis of Allergic Fungal Sinusitis vs a Mucocele

Arch Otolaryngol Head Neck Surg. 1999;125(10):1169. doi:10.1001/archotol.125.10.1169

The cover of the September 1998 issue of the ARCHIVES showed axial and coronal magnetic resonance (MR) views of a sinus lesion.1 Underneath was the question, "What is your diagnosis?" My diagnosis is allergic fungal sinusitis, rather than the answer given on the Resident's Page, which was "Mucocele." On page 1046, the axial computed tomographic (CT) image shows an expansile ethmoid mass with irregular areas of high attenuation. The T1-weighted MR image shows linear areas of high signal corresponding to mucosal lining of ethmoid cells, with central low signal in a very irregular pattern. The clinical history is that of a 15-year-old boy with progressive proptosis and ipsilateral nasal polyps.

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