Fruiting Bodies of Aspergillus in a Cavitary Lung Mass: A Rare Finding on Fine Needle Aspiration

IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY
Maria Luisa C. Policarpio-Nicolas, Jacob Rattin, Sanjay Mukhopadhyay
{"title":"Fruiting Bodies of Aspergillus in a Cavitary Lung Mass: A Rare Finding on Fine Needle Aspiration","authors":"Maria Luisa C. Policarpio-Nicolas,&nbsp;Jacob Rattin,&nbsp;Sanjay Mukhopadhyay","doi":"10.1002/dc.70014","DOIUrl":null,"url":null,"abstract":"<p>Endobronchial ultrasound (EBUS) guided fine needle aspiration is a modality for diagnosing lung nodules as well as fungal organisms. One of the most frequently isolated fungal organisms from immunocompromised patients or immunocompetent patients with severe COPD is <i>Aspergillus</i> spp.<i>,</i> which is characterized by septate hyphae with progressive dichotomous branching. However, this finding is not entirely specific to <i>Aspergillus</i> spp. since it can be seen in non-Aspergillus fungi. Nonetheless, the presence of fruiting bodies, background inflammation, and in correlation with the clinical and radiologic findings are supportive of <i>Aspergillus</i> infection. This case report describes a 73-year-old male smoker with severe COPD who presented with multiple lung nodules and hilar lymphadenopathy. An EBUS guided fine needle aspiration of the largest left lung cavitary nodule showed the presence of uniformly sized, septate hyphae with progressive dichotomous branching. There were randomly distributed fruiting bodies composed of a smooth stalk, a swollen vesicle at the terminal end of the stalk, and a single row of phialides occupying the upper two-thirds of the vesicle. The background showed marked acute inflammation and singly dispersed conidia (spores). The GMS stain highlighted the presence of fruiting bodies, dichotomous branching septate hyphae, and singly dispersed conidia. The Fungal PCR result confirmed the presence of <i>Aspergillus fumigatus</i>. Hence, the presence of fruiting bodies is extremely helpful in the identification of the <i>Aspergillus</i> spp. over the other non-Aspergillus fungi. While species identification is often performed in culture, the cytomorphology of the fruiting body could favor <i>Aspergillus</i> spp., which could facilitate prompt medical management.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 11","pages":"576-579"},"PeriodicalIF":1.0000,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dc.70014","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diagnostic Cytopathology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/dc.70014","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Endobronchial ultrasound (EBUS) guided fine needle aspiration is a modality for diagnosing lung nodules as well as fungal organisms. One of the most frequently isolated fungal organisms from immunocompromised patients or immunocompetent patients with severe COPD is Aspergillus spp., which is characterized by septate hyphae with progressive dichotomous branching. However, this finding is not entirely specific to Aspergillus spp. since it can be seen in non-Aspergillus fungi. Nonetheless, the presence of fruiting bodies, background inflammation, and in correlation with the clinical and radiologic findings are supportive of Aspergillus infection. This case report describes a 73-year-old male smoker with severe COPD who presented with multiple lung nodules and hilar lymphadenopathy. An EBUS guided fine needle aspiration of the largest left lung cavitary nodule showed the presence of uniformly sized, septate hyphae with progressive dichotomous branching. There were randomly distributed fruiting bodies composed of a smooth stalk, a swollen vesicle at the terminal end of the stalk, and a single row of phialides occupying the upper two-thirds of the vesicle. The background showed marked acute inflammation and singly dispersed conidia (spores). The GMS stain highlighted the presence of fruiting bodies, dichotomous branching septate hyphae, and singly dispersed conidia. The Fungal PCR result confirmed the presence of Aspergillus fumigatus. Hence, the presence of fruiting bodies is extremely helpful in the identification of the Aspergillus spp. over the other non-Aspergillus fungi. While species identification is often performed in culture, the cytomorphology of the fruiting body could favor Aspergillus spp., which could facilitate prompt medical management.

Abstract Image

肺腔肿块中曲霉子实体:细针穿刺的罕见发现。
支气管超声(EBUS)引导细针穿刺是诊断肺结节和真菌生物的一种方式。从免疫功能低下患者或免疫功能正常的严重慢性阻塞性肺病患者中最常分离到的真菌生物之一是曲霉,其特征是菌丝分离,具有进行性二分分支。然而,这一发现并不完全针对曲霉属,因为它可以在非曲霉属真菌中看到。尽管如此,子实体的存在、背景炎症以及与临床和放射学表现的相关性都支持曲霉感染。这个病例报告描述了一个73岁的男性吸烟者与严重的慢性阻塞性肺病谁提出了多个肺结节和肺门淋巴结病。EBUS引导下细针穿刺最大的左肺空洞结节,可见大小均匀、分隔的菌丝,并呈进行性二分分支。子实体是随机分布的,子实体由光滑的茎和茎末端肿胀的囊泡组成,单排小柱占据囊泡上部的三分之二。背景显示明显的急性炎症和单分散的分生孢子(孢子)。GMS染色显示存在子实体,二分枝分离菌丝和单分散的分生孢子。真菌PCR结果证实了烟曲霉的存在。因此,子实体的存在对鉴别曲霉属真菌和其他非曲霉属真菌非常有帮助。虽然菌种鉴定通常在培养中进行,但子实体的细胞形态学可能有利于曲霉,这可以促进及时的医疗管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Diagnostic Cytopathology
Diagnostic Cytopathology 医学-病理学
CiteScore
2.60
自引率
7.70%
发文量
163
审稿时长
3-6 weeks
期刊介绍: Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信