Date: 3 February 2014
E. 6 months later- yellow secretions cleared after suction
Copyright:
(© Fungal Research Trust)
Notes:
Initially it was incorrectly diagnosed as a bronchial carcinoma.
The material was allergic mucin with mucus and cellular debris arranged in a layered pattern. Cellular debris was almost entirely eosinophils with scattered Charcot-Leyden crystals. A Grocott stain showed multiple branching fungal hyphae, consistent with Aspergillus spp. Subsequently her total IgE rose to 750 KIU/L and Aspergillus specific RAST to 14.9 KUa/L.
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Nodules and areas of atelectasis are seen at both bases. He later died.
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Further details
It is clearly a relatively small cavitary lesion, and the patient was almost asymptomatic. This response was a ‘stable’ response. The patient was included in the report Denning DW, Lee JY, Hostetler JS, Pappas P, Kauffman CA, Dewsnup DH, Galgiani JN, Graybill JR, Sugar AM, Catanzaro A, Gallis H, Perfect JR, Dockery B, Dismukes WE, Stevens DA, NIAID Mycoses Study Group multicenter trial of oral itraconazole therapy of invasive aspergillosis. Am J Med 1994; 97: 135-144.
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Well demarcated pulmonary infarction is well seen in this close-up of the lung at autopsy in a patient with histologically confirmed invasive aspergillosis. Angio invasion is characteristic of invasive aspergillosis, is associated with a worse prognosis, but is not always seen.
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This 83 year old man presented with weight loss to a lung cancer clinic in mid 2003.
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