Date: 6 August 2015
Percutaneous biopsy needle is seen vertically above the back
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Notes:
Under CT scan guidance, with the patient lying on their front, a percutaneous biopsy needle is seen vertically above the back, penetrating the skin, subcutaneous tissue and between 2 ribs. It is aimed at a an inflammatory area in the upper lobe of the lung, which defied diagnosis by other means. This area is much larger to access than the tiny nodule seen in in an identical location in the other lung. The lungs show considerable destruction of normal architecture, typical of emphysema with bullae, indicating that the patient was a heavy smoker.
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Drug rashes: Drug interactions between steroids and anti-fungal drugs – (ecchymosis)
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Reference: Muco-cutaneous retinoid effects and facial erythema related to the novel triazole antifungal agent voriconazole. Denning, DW & Griffiths, CEM. Clin.Exp Dermatol 2001, 26(8), 648-53.
Courtesy of Dr D Denning, Wythenshawe Hospital, Manchester.(© Fungal Research Trust),
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Micrographs of A. niger conidia & conidial heads provided by Amaliya Stepanova, Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation.
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Micrographs of A. terreus conidia & conidial heads provided by Amaliya Stepanova, , Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation.
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Micrographs of A. fumigatus conidia & conidial heads provided by Amaliya Stepanova, , Head of Laboratory pathomorphology and cytology at Kashkin Research Institute, Russian Federation.
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Patients has history of ABPA complicating long standing asthma. His total IgE has fluctuated between 2,200 and 4,600 KU/L, his Aspergillus IgE between 36.3 and 65.4 kAU/L and Aspergillus IgG from 87-154 mg/L. He has been taking long term itraconazole.
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