Date: 26 November 2013
Further details
Image A. Multiple ring enhancing abscesses with substantial surrounding oedema was demonstrated. He had no focal neurological deficits. A needle aspiration confirmed the clinical impression of cerebral aspergillosis by culture and microscopy.
Image B. Resolution of cerebral aspergillosis, pt MN. Focal scars with some surrounding oedema are seen in the site of the prior abscesses.
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The chest x-ray shows a patient who had a left lung transplanted in May 2003 for cryptogenic fibrosing alveolitis, which was diagnosed post-transplant as sarcoidosis.
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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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