A 45-year-old man presents with chest pain, fever, productive cough, and rust-colored sputum. The patient was diagnosed with tuberculosis in his early 20s. A chest X-ray shows multiple, nodular infiltrates and cavitary lesions. A lung biopsy reveals necrotizing inflammation and vascular thrombi with branching fungal hyphae. Which of the following is the most likely diagnosis?
Correct Answer: Aspergillosis
Description: Fungus balls (aspergillomas) consist of rounded, lobulated masses of hyphae and occur in patients with a previous history of cavitating pulmonary disease (e.g., pulmonary tuberculosis). Aspergillus is a common environmental fungus that causes opportunistic infections in the lungs. Inhaled spores germinate in the warm humid atmosphere provided by cavitary lung lesions, filling them with masses of hyphae. The organisms generally do not invade the lung parenchyma. There are three different types of pulmonary aspergillosis, namely allergic bronchopulmonary aspergillosis, aspergillomas, and invasive aspergillosis. Candidiasis (choice C) is incorrect because Candida infections are not typically angioinvasive. The other choices do not show characteristic branching fungal hyphae.Diagnosis: Pulmonary aspergillosis, aspergilloma
Category:
Pathology
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