Date: 14 September 2015
Mr RM is 80 and an ex-coal miner.He developed pneumoconiosis from exposure to coal dust. He also developed rheumatoid arthritis and the combination of this disease and pneumoconiosis is called Caplan’s syndrome.
His chest Xray in early 2015 shows extensive bilateral pulmonary shadowing with solid looking nodules superimposed on abnormal lung fields, contraction of his left lung with an elevated diaphragm and a large left upper lobe aspergilloma, displaying a classic air crescent. His CT scan from mid 2014 demonstrates a large aspergilloma in a cavity on the left, with marked pleural thickening around it, which is partially ‘calcified’ towards its base. Inferiorly on other images,remarkable pleural thickening and fibrotic irregular and spiculated nodules are seen, most partially calcified.
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Images library
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Mucous plug examined by light microscopy with KOH, showing a network of hyaline branching hyphae typical of Aspergillus, from a patient with ABPA.
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Corneal scraping stained with lactophenol cotton blue showing beaded septate hyphae not typical of either Fusarium spp or Aspergillus spp, being more consistent with a dematiceous (ie brown coloured) fungus
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Corneal scrape with lactophenol cotton blue shows separate hyphae with Fusarium spp or Aspergillus spp.
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A filamentous fungus in the CSF of a patient with meningitis that grew Candida albicans in culture subsequently.
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Transmission electron micrograph of a C. neoformans cell seen in CSF in an AIDS patients with remarkably little capsule present. These cells may be mistaken for lymphocytes.
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India ink preparation of CSF showing multiple yeasts with large capsules, and narrow buds to smaller daughter cells, typical of C. neoformans
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PAS stain. An example of Aspergillus fumigatus.
(PAS-stained) in a patient with chronic granulomatous disease showing a 45 degree branching hypha within a giant cell. Rather bulbous hyphal ends are also seem, which is sometimes found inAspergillus spp. infections, histologically. (x800)
