Chronic necrotizing bronchopulmonary aspergillosis with elements of bronchocentric granulomatosis.
Chronic necrotizing pulmonary aspergillosis (CNPA) is an unusual form of pulmonary aspergillosis arising in the setting of mildly immune compromised state or altered local defense system. CNPA rarely shows histological findings mimicking bronchocentric granulomatosis (BCG), which is characterized by peribronchiolar granulomatous destruction. We describe a case representing CNPA with elements of BCG. A-64 year-old woman was admitted because of atypical pneumonia with multi-focal variable sized consolidations and cavitary lesions on high-resolution computed tomography (HRCT). The open lung biopsy specimen showed large areas of necrotizing pneumonia with some scattered aspergillus hyphae within the lung parenchyma. Some terminal bronchioles were found to be destroyed and were replaced by peribronchiolar granulomatous inflammation. There was no evidence of angioinvasion by aspergillus or aspergillous emboli. Despite vigorous antifungal agent and steroid treatment, she died of acute airway obstruction by bronchial casts on the thirty-fourth hospital day.
Kim
Doh Hyung
DH
Dankook University Medical Center, Division of Pulmonary Medicine, 16-5 Anseo-dong, Chonan, Republic of Korea.
Lee
Jae Hyun
JH
Kim
Byung Ha
BH
Choi
Eun Kyung
EK
Park
Jae Seok
JS
Kim
Keun Youl
KY
Choi
Young Hi
YH
Myong
Na Hye
NH
Lee
Kye Young
KY
D001228:Aspergillosis / Q000209:etiology / Q000473:pathology*; D002908:Chronic Disease; D005260:Female; D006099:Granuloma / Q000209:etiology / Q000473:pathology; D006801:Humans; D008172:Lung Diseases, Fungal / Q000209:etiology / Q000473:pathology*; D008875:Middle Aged; D009336:Necrosis