Ultrastructural interaction between multinucleate giant cells and the fungus in aspergillomas of human paranasal sinuses.

The interaction between multinucleate giant cells (MGCs) and the fungus Aspergillus flavus as seen by transmission electron microscopy (TEM) is described in paranasal granulomas occurring in a Saudi patient dying from chronic aspergillosis. Two morphologically different types of MGCs were recognized; these were: a) 'Unhealthy looking' type I cells, rich in well organized organelles and containing few, partially degenerated and necrotic fungal elements. b) 'Healthy looking' type II cells that contained scanty, randomly dispersed cell organelles and normal, or partially degenerated fungal hyphae. The fungal elements had very thick and multilayered cell walls, and were found either in close contact to the host cell cytoplasm, or enclosed within phagosomes. The mechanism of the fungus destruction by the host MGCs is described and compared with that previous reports of MGCs involved in the elimination of extracellular microorganisms. The morphology and the various physiological activities of MGCs seems to depend mainly on whether the pathogen is extra- or intracellular. However, this study showed that MGCs are the cells best suited for killing pathogenic fungi.