Secondary metabolites, structure diagram: Trivial name – Citraconic anhydride metabolite 1

Lung transplant patient with a left lower lobe bronchial stent

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.

Great pleural thickness and two cavities.

Gross pathology demonstrating the great pleural thickness and two cavities (upper lobe and superior segment of lower lobe) with fragments of fungal mass.

Multiple aspergillomas, Patient CR.

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Histopathological appearance of a fungus ball.

Histopathological appearance of a fungus ball. Note a conidial head resulting from fungal exposure to the air.

Fungus ball caused by Scedosporium apiospermum.

Histopathological appearance of a fungus ball caused by Scedosporium apiospermum. The presence of anneloconidia differentiates it from Aspergillus.

Hyaline hyphal and calcium oxalate crystals

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).

Aspergillus niger fungus ball and acute oxalosis.

Aspergillus niger fungus ball and acute oxalosis. Higher magnification of adjacent replicate section.

Oxalate crystals within renal tubuli.

Oxalate crystals within renal tubuli (H&E, phase contrast, x 100). This patient developed acute oxalosis.

Dead fungal ball.

Gross appearence, aspergilloma

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Lung surface. Fungus ball, severe parenchymal fibrosis and pleural thickening.

Lung surface. Fungus ball, severe parenchymal fibrosis and pleural thickening.