Date: 27 January 2014
Copyright:
Fungal Research Trust
Notes:
This 73 year old patient with CPA in right upper lobe and COPD who was also a heavy smoker, showed evidence of finger clubbing ( A,B,C). He has been on long term itraconazole, in 1990 he had an oesophagectomy for cancer of the oesophagus. Finger clubbing is an uncommon symptom only seen in advanced or chronic disease. D, chest X ray there are background changes nof COPD with loss of volume in the right hemithorax and a right apical cavititating lesion.
Images library
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Title
Legend
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Gross pathology demonstrating the great pleural thickness and two cavities (upper lobe and superior segment of lower lobe) with fragments of fungal mass.
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Histopathological appearance of a fungus ball. Note a conidial head resulting from fungal exposure to the air.
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Histopathological appearance of a fungus ball caused by Scedosporium apiospermum. The presence of anneloconidia differentiates it from Aspergillus.
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Chronic necrotising aspergillosis. Hyaline hyphal and calcium oxalate crystals obtained by needle aspirate biopsy from a diabetic patient with chronic necrotizing aspergillosis caused by Aspergillus niger (Papanicolaou, x 100).
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Aspergillus niger fungus ball and acute oxalosis. Higher magnification of adjacent replicate section.
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Oxalate crystals within renal tubuli (H&E, phase contrast, x 100). This patient developed acute oxalosis.
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Lung surface. Fungus ball, severe parenchymal fibrosis and pleural thickening.
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The periphery of the fungus ball is deeply eosinophilic because of the deposition of Splendore-Hoeppli material.
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