《Slide 47.》Aspergillosis, Lung

A. Brief Descriptions：

1. Colonizing aspergillosis (aspergilloma) : proliferating fungal hyphae (fungus balls) form brownish masses lying free within the cavities.

2. Invasive aspergillosis.

B. Gross Findings：

      略.

C. Micro Findings：

1. Accumination of fungal hyphae as a fungal ball in the destructed lung parenchyma, known as “ ball in hale ”.

2. Cavitaction with densely inflammatory infiltration.

3. Fungal hyphae: narrow ( 3~5 m m ), separated, dichotomous, acute branching angle.

D. Others:

1. Caused by those of aspergillous genus: A. fumigatus, A. flavus, A. niger.

2. Fungal hyphae: narrow ( 3~5 m m ), separated, dichotomous, acute branching angle.

3. Special stains: GMS. or PASD.

4. Infection produces several different pattern of disease, depending on the degree of tissue reaction and host reaction.

5. In reading our slide :

• Hemorrhagic center surround by necrotic debris.

• Fungal element can be found in necrotic debris.

type	presentation	test	microscopy	gross
allergic	asthma, adult	skin test for aspergillous antigen	collapse & consolidation of affected area eosinophil rich mucus goblet-cell hyperplasia	Patchy Consolidation
invasive	in immuno- compromised patient		invade bronchial wall & paren- chyma produce neutrophilic reaction invade blood vessel frequently characteristic branching (45° ) (A.niger, A. fumigatus)	Hemorrhagic Center Surrounded by necrosis
saprophytic	aspergilloma in TB or bron-chioectasia	X-ray	fibrous wall cavity contain necrotic debris, fibrin, and mass of fungal element	ball in hole

E. Reference：

1. Robbins Pathologic Basis of Disease, 6^th ed.  P.379-380.

　

 

 

【 Fig. 47-1 (LP)】

　

 

 

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【 Fig. 47-3 (HP)】

　

 

 

【 Fig. 47-4 (HP)】