Lung nontumor
Infections
Aspergillus

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 26 May 2017, last major update August 2011

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed search: aspergillus [title] lung infection

Cite this page: Aspergillus. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lungnontumoraspergillosis.html. Accessed December 17th, 2017.
Definition / general
Clinical features
  • Aspergillus infection is associated with solid organ or bone marrow transplants and antileukemic chemotherapy; relatively uncommon in AIDS patients
  • Allergic bronchopulmonary aspergillosis: bronchocentric granulomas in asthmatics that contain numerous eosinophils and noninvasive aspergillus organisms or other fungi (Clin Dev Immunol 2011;2011:843763); patients have elevated IgE directed against aspergillus antigens, also thick mucus plugs; impacted mucus may form cast of airways (plastic bronchitis); over time, bronchi become dilated, causing bronchiectasis; patients develop intractable bronchospasm; rarely other fungi cause similar disease
  • Bronchocentric granulomatosis: cell mediated reaction to aspergillus in airway; circumferential granulomatous inflammation surrounding small airways with mucus and cellular debris and loss of lining epithelium within airway (Radiographics 2007;27:617); may be isolated or part of allergic bronchopulmonary aspergillosis; rarely due to other fungi
  • References: J Bras Pneumol 2009;35:1238
Diagrams / tables

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Invasive aspergillosis by Aspergillus fumigatus

Gross description
  • Invasive disease usually shows targetoid lesions with peripheral consolidation and central thrombosed vessels due to angioinvasive fungi; variable bronchopneumonia or lobar pneumonia
Gross images

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Abscess

Aspergilloma

Microscopic (histologic) description
  • Dichotomous (into two nearly equal branches, or 45 degrees) branching, hyphae with frequent septation, diameter ranges from 2.5 to 4.5 μm
  • May see aspergillus fruiting body (other fungi may mimic aspergillus, in general, should not definitively diagnose aspergillosis in tissue without the presence of a fruiting body), and often invades vessels
Microscopic (histologic) images

Images hosted on PathOut server:

PAS stains, contributed by Professor Venna Maheshwar, Drs. Kiran Alam and Anshu Jain, J. N. Medical College, India

Aspergilloma: Left: GMS;
middle: H&E; right: PAS;
contributed by Dr. Claudia
Mendez, Bogota, Columbia



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Fungus ball

Hyphae


Bronchocentric granulomatosis in asthma patient

Phialoconidia of Aspergillus fumigatus

PAS stain


PAS stains, contributed by Dr. Claudia Mendez, Bogota, Columbia

GMS stain

Virtual slides

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Aspergillus

Cytology images

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Allergic bronchopulmonary
aspergillosis with
coexistant aspergilloma

Invasive aspergillus tracheobronchitis:
abundant necrotic material with
multiple mycelia, consisting of septate
hyphae branching at 45 degrees