Question: An immunocompetent 23 year old female presents with 3 years of left nasal airway obstruction and rhinorrhea. Examination reveals dense polyposis on the left side only. CT is obtained that shows heterogenous signal in the left maxillary, ethmoid, frontal, and sphenoid sinuses with inflammatory changes in the nasal cavity. A specimen of thick drainage is sent to pathologist who contacts you after noting copious eosinophils and what other characteristic feature?

a) Narrow branching hyphae within vessels

b) Broad based fungal buds

c) Atypical appearing cells with prominent nucleoli

d) Charcot-Leyden crystals

[Answer will be posted with next week's new question]

Answer to last week's question, "Ch-ch-ch-changes" (March 11, 2019)

Demodex folliculorum.