title: Aspergillus in cytology specimens: a review of 45 specimens from 36 patients.
abstract: OBJECTIVE
  To assess the clinical significance associated with the identification of fungal elements consistent with Aspergillus in cytology specimens.
  
  
  METHODS
  For all cytology specimens with reported fungal elements consistent with Aspergillus, reported over a 9 yr and 8 mo period at The Cleveland Clinic Foundation, the patient's medical charts were reviewed with particular attention to underlying disease, presentation, treatment, and clinical course. Cytology results were compared with available microbiologic cultures and tissue specimens in all of the patients.
  
  
  RESULTS
  Forty-five cytology specimens with Aspergillus fungal forms, from 36 patients, were identified. Twenty-six patients had concurrent specimens sent for culture in whom II grew Aspergillus species (10 Aspergillus fumigatus), eight grew organisms other than Aspergillus, and seven were no growth. A total of 16 patients (44%) were treated with antifungal treatment (Amphotericin B). Treatment with Amphotericin B was significantly associated with a concurrent growth of Aspergillus species (9/11 patients with Aspergillus culture positive vs. 7/25 patients without a positive culture for Aspergillus, P value = 0.004 (ODDS ratio = 11, 95% confidence interval:#1.6-104, 2-tailed Fisher exact test.)
  
  
  CONCLUSIONS
  The presence of fungal forms consistent with Aspergillus in cytology specimens is neither specific nor sensitive for significant infection due to Aspergillus. Treatment with Amphotericin B is more likely to be instituted when a concurrent clinical specimen grows Aspergillus species in culture.
authors.affiliation: Department of Anatomic Pathology/L25, Cleveland Clinic Foundation, OH 44195, USA.
authors.forename: D F
authors.initials: DF
authors.lastname: Fischler
authors.forename: G S
authors.initials: GS
authors.lastname: Hall
authors.forename: S
authors.initials: S
authors.lastname: Gordon
authors.forename: M H
authors.initials: MH
authors.lastname: Stoler
authors.forename: C
authors.initials: C
authors.lastname: Nunez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001228:Aspergillosis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*; D001230:Aspergillus / Q000145:classification / Q000302:isolation & purification*; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged