Date: 26 November 2013
Transverse sections through the thorax of a patient with AIDS, hepatitis C and a left tempero-parietal cerebral lymphoma. His CD4 cell count was 45 x 106 / l. The lymphoma was proven by biopsy after a poor response to anti-toxoplasma therapy. He was given dexamethasone to cover the surgery and then developed diabetes mellitus. He did not receive chemotherapy for his lymphoma but did have 2 cerebral radiotherapy treatments (1.8 Gy each). Three weeks after the biopsy he developed dyspnoea and fever. Shortly after this he developed a right-sided hemiparesis, became comatose and died 2 days later.Autopsy showed a cerebral lymphoma and pulmonary and renal aspergillosis. Aspergillus nidulans was recovered from cultures of lungs and kidney.
Copyright:
Images submitted by Dr. Cornelia Lass-Floerl, University of Innsbruck – Institute of Hygiene; the case team includes: Dr. Mario Sarcletti, Dr. Alfons Stöger and Prof. Hans Maier all at the University of Innsbruck.
Notes: n/a
Images library
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Title
Legend
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Necrotic lung tissue in culture
Af=Colony of Aspergillus fumigatus
B=bacterial colonies
L=lung tissue
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A photograph of part of the upper lung lobe of an immunosuppressed patient. The lung tissue shows extenive areas of necrosis due to invasive colonisation.
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A photograph of a cavity in the upper lobe of the lung of a patient with ankylosing spondylitis. Such cavitation,which may be confused with prior tuberculosis, can follow fibrosis.
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Plugs stained with Methenamine/silverActively growing mycelia of the fungus are a deep brown/black. Counterstaining shows the dense mucus of the plugs as predominantly orange.
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Sputum from an asthmatic patient showing plugs(casts). The development of plugs coincided with an increased prevalence and severity of episodes of asthma
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microscopic characters Conidiophore stipes(C)1300-2800um long:Vesicles(V)40-70um wide,clavate:Phialides(Ph) uniseriate:Conidia(Con)3.5-4.0um long,smooth walled.
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microscopic characters Conidiophore stipes(C)225-350um arising from hyphae(Hy):Vesicles(Ves)15-25um wide:Phialides(Ph)uniseriate:Conidia(Con)2.4-3.0um spherical to ovoid,roughened.
