Grocott (silver) stain showing branching septate hyphae fairly typical of Aspergillus in mucus.

Grocott (silver) stain showing branching septate hyphae fairly typical of Aspergillus in mucus. The apparent right angle branching is unusual.
Mucoid impaction due to ABPA- Pt DL.A 57 year old woman presented with breathlessness. She had a history of mild asthma for which she occasionally took salbutamol inhaler puffs. The patient underwent a pneumonectomy because of the severity of her disease process, and uncertainty about the diagnosis, prior to serology results being obtained.Serology showed an IgE of 2600, with a strongly positive Aspergillus RAST test and weakly positive Aspergillus precipitins. Material removed at bronchoscopy showed eosinophilia. These features confirm a diagnosis of allergic bronchopulmonary aspergillosis (ABPA).