title: Conidial heads (Fruiting Bodies) as a hallmark for histopathological diagnosis of angioinvasive aspergillosis.
abstract: Aspergillosis is a mycosis that afflicts immunocompetent and immunocompromised hosts; among the former it exhibits different clinical pictures, and among the latter the infection renders an invasive form of the disease. The histologic diagnosis of invasive aspergillosis is somewhat challenging mostly because of some morphological similarities between other fungi. However, when present, the conidial heads are pathognomonic of aspergillosis. The authors present the case of a 68-year-old woman who was submitted to autologous hematopoietic stem cell transplantation in the pursuit of multiple myeloma treatment. The post-transplantation period was troublesome with the development of severe neutropenia, human respiratory syncytial virus pneumonia, and disseminated aspergillosis, which was suspected because of a positive serum galactomannan antigen determination, and resulted in a fatal outcome. The autopsy findings showed diffuse alveolar damage associated with angioinvasive pulmonary aspergillosis with numerous hyphae and conidial heads in the lung parenchyma histology. The authors call attention to the aid of autopsy in confirming the diagnosis of this deep mycosis, since only the research of the galactomannan antigen may be insufficient and uncertain due to its specificity and of the possibility of false-positive results.
authors.affiliation: Pathology Department - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil .
authors.forename: Luciana Depiere
authors.initials: LD
authors.lastname: Lanzarin
authors.affiliation: Hematopoietic Stem Cell Transplantation Division - Hospital das Clínicas - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil .
authors.forename: Livia Caroline Barbosa
authors.initials: LC
authors.lastname: Mariano
authors.affiliation: Hematopoietic Stem Cell Transplantation Division - Hospital das Clínicas - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil .
authors.forename: Maria Cristina Martins de Almeida
authors.initials: MC
authors.lastname: Macedo
authors.affiliation: Infectious and Parasitic Diseases Department - Hospital das Clínicas - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil.; Hematopoietic Stem Cell Transplantation Division - Hospital das Clínicas - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil.
authors.forename: Marjorie Vieira
authors.initials: MV
authors.lastname: Batista
authors.affiliation: Pathology Department - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil.; Emergency Department - Hospital das Clínicas - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil.
authors.forename: Amaro Nunes
authors.initials: AN
authors.lastname: Duarte
keywords: Aspergillus; Autopsy; Neutropenia, Hematopoietic Stem Cell Transplantation