Whereas the isolation of Aspergillus species with conventional culture techniques is predictive of CPA, diagnosis of chronic pulmonary aspergillosis (CPA) mostly relies on serologic Aspergillus precipitin test and findings on images, because culture is limited by poor sensitivity. Therefore, definitive diagnosis of CPA usually caused by Aspergillus spp. frequently presents difficulties. The aim of this study is to evaluate the diagnostic value of cytological identification of fungal elements in the diagnosis of CPA. Data from a total of histologically proven 19 patients were analyzed and evaluated using our modified Grocott’s staining techniques. We compared the efficacy and diagnostic value of cytological identification of fungal elements with that of other detection techniques for diagnosis of pulmonary aspergillosis. Serum IgG antibodies to Aspergillus were positive in most of subjects (92%), but standard cultures were positive in 2 of 15 patients (13%). Cytology detected 12 of 19 cases of CPA, had a sensitivity of 63.2% for detection of filamentous fungi, while no fungal elements were detected in all control subjects that were not histologically diagnosed as pulmonary aspergillosis. No statistically significant differences were observed in cytological identification with respect to various serological tests, culture results, and cavity size. The type of cytological preparations (bronchoscopic cytology examination and expectorated sputum cytology) has a tendency to affect detection of the fungal elements (p = 0.0577). The result suggests that cytological identification of fungal elements in CPA may give a better contribution to assist clinical diagnosis for CPA.
Full conference title:
- ISHAM 19th (2015)