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| Aspergilloma and Invasive Aspergillus |
| Etiology • Aspergillus spores are widely disseminated in nature. • Inhalation leads to disease. |
| Pathogenesis • Organisms will proliferate in a pre-existing cavity in a immunocompetent host. • Organisms will invade in the immunodeficient host. , |
| Epidemiology • Patients who have bronchiectasis secondary to obstruction, cystic fibrosis, sequestration etc. • Patients who have tuberculosis. • Patients who have abscesses. • Immunocomporomsied individuals. |
| General Gross Description • Preexisting pulmonary cavity (old abscess, infarct etc) filled with brown debris • Patients with invasive aspergillus will have multiple, hemorrhagic, firm nodules which may be centered around blood vessels. |
| General Microscopic Description • Cavity often lined by squamous epithelium with profound cytologic atypia which may be confused with squamous carcinoma • Septate hyphae with branching at an acute angle • Fruiting bodies may be seen • In imunocompromised patients hyphae are seen invading bessel walls surrounded by necrosis and hemorrhage. |
| Clinical Correlation • Relatively asymptomatic patients with recurrent hemoptysis • Or desperately ill immunosupressed patients. |
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 353-4. |
| Aspergilloma and Invasive Aspergillus |
| Synopsis by: Melinda Sanders M.D. (T28000E40610)[121] |
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