Lung nontumor

Topic Completed: 1 August 2011

Revised: 29 January 2019, last major update August 2011

Copyright: (c) 2003-2018,, Inc.

PubMed search: aspergillus [title] lung infection

Elliot Weisenberg, M.D.
Page views in 2019: 12,720
Page views in 2020 to date: 4,867
Cite this page: Weisenberg E. Aspergillus. website. Accessed May 30th, 2020.
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

Images hosted on other servers:

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

Images hosted on other servers:



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

Images hosted on other servers:

Fungus ball


Bronchocentric granulomatosis in asthma patient

Phialoconidia of Aspergillus fumigatus

PAS stain

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

GMS stain

Cytology images

Images hosted on other servers:

Allergic bronchopulmonary
aspergillosis with
coexistant aspergilloma

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

Back to top