Allergic fungal sinusitis (or eosinophilic fungal rhinosinusitis)

Airways (tracheobronchial)

Bronchoscopic manifestations of Aspergillus tracheobronchitis. (a) Type I. Inflammatory infiltration, mucosa hyperaemia and plaques of pseudomembrane formation in the lumen without obvious airway occlusion. (b) Type II. Deep ulceration of the bronchial wall. (c) Type III. Significant airway occlusion by thick mucous plugs full of Aspergillus without definite deeper tissue invasion. (d) Type IV. Extensive tissue necrosis and pseudomembrane formation in the lumen with airway structures and severe airway occlusion (Wu 2010).

Airways (tracheobronchial)

High resolution CT showing centrilobular nodular opacities and branching linear opacities (tree-in-bud appearance) (Al-Alawi 2007).

Airways (tracheobronchial)

Chest X-ray showing poorly defined bilateral nodular opacities (Al-Alawi 2007).

Obstructing tracheobronchitis

Mucus plugs seen obstructing the lumen of the bronchi (Kramer 2005).

Invasive tracheobronchitis

Gross pathologic specimen from autopsy shows the bronchial lumen covered by multiple whitish endobronchial nodules (arrows) (Franquet 2002).

Invasive tracheobronchitis

Invasive tracheobronchitis showing numerous nodules seen during bronchoscopy (Ronan D’Driscoll).

Pseudomembranous tracheobronchitis

Pseudomembranous seen overlying the bronchial mucosa (Tasci 2006).

High power microscopy of H&E strained mucus plug

Microscopy of a fungal plug

Low power microscopy of H&E strained mucus plug

Microscopy of a fungal plug

Medium power microscopy of H&E strained mucus plug

Microscopy of a fungal plug