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Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
Published on: March 9, 2018
The pathology of pulmonary disorders due to Aspergillus spp
Richard L Kradin1, Eugene J Mark
1Department of Pathology, Warren 253, Massachusetts General Hospital, Boston, MA 02114, USA. rkradin@partners.org
Abstract:
Diagnosing the range of pulmonary disorders caused by Aspergillus spp can be challenging. In instances of hypersensitivity responses to Aspergillus spp (ie, allergic bronchopulmonary aspergillosis, bronchocentric granulomatosis, and hypersensitivity pneumonitis), the surgical pathologist must be cognizant of their relationship to infection, as fungal organisms may be rare or absent from the biopsy specimens. Within the spectrum of opportunistic infection, it is critical to distinguish Aspergillus spp from other fungal mimics, as well as to discern whether infection is limited, progressive, or immanently life threatening. However, the surgical pathologist who establishes expertise in this area will be rewarded by the satisfaction of having contributed primarily to an important area of patient care. This article reviews the spectrum of pulmonary disorders due to infection by Aspergillus spp, with emphasis on the clinical implications of diagnosis.
Insights
Diagnosing pulmonary Aspergillus infections can be difficult, as fungal organisms may be absent in hypersensitivity conditions. Accurate diagnosis by surgical pathologists is crucial for patient care.
Area of Science:
- Pulmonology
- Mycology
- Pathology
Background:
- Pulmonary disorders caused by Aspergillus species present diagnostic challenges.
- Hypersensitivity responses to Aspergillus (e.g., allergic bronchopulmonary aspergillosis) may lack identifiable fungal organisms in biopsies.
- Distinguishing Aspergillus infections from mimics and assessing their severity is critical.
Purpose of the Study:
- To review the spectrum of pulmonary disorders caused by Aspergillus species.
- To emphasize the clinical implications of accurate diagnosis in surgical pathology.
- To highlight the importance of differentiating Aspergillus infections from other conditions.
Main Methods:
- Review of the literature on pulmonary Aspergillus infections.
- Analysis of diagnostic challenges in surgical pathology.
- Emphasis on clinical correlation and differential diagnosis.
Main Results:
- Aspergillus-related pulmonary conditions range from hypersensitivity reactions to invasive infections.
- Fungal organisms can be scarce or absent in hypersensitivity syndromes.
- Accurate differentiation is key to determining infection status (limited, progressive, or life-threatening).
Conclusions:
- Surgical pathologists play a vital role in diagnosing pulmonary Aspergillus disorders.
- Expertise in identifying Aspergillus and its mimics is essential for patient management.
- Timely and accurate diagnosis significantly impacts patient care and outcomes.
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