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Pulmonary aspergillosis with bronchocentric granulomas
N Nagata1, K Sueishi, K Tanaka
1Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
The American Journal of Surgical Pathology
|May 1, 1990
Summary
This study documents a rare case of pulmonary aspergillosis in a non-asthmatic, non-immunocompromised patient. The findings reveal bronchocentric granulomas caused by Aspergillus, successfully treated with an antifungal drug.
Area of Science:
- Pulmonology
- Mycology
- Pathology
Background:
- Pulmonary aspergillosis typically affects immunocompromised individuals or those with asthma.
- Bronchocentric granulomas are a less common manifestation of fungal lung infections.
Observation:
- A 56-year-old Japanese man, with no history of asthma or immunosuppression, presented with cough and sputum.
- Chest X-ray revealed abnormalities, and lung biopsy showed necrotizing granulomas centered on bronchioles.
- Microscopic examination identified Aspergillus hyphae within the granulomas, with no signs of allergic reaction.
Findings:
- The case presents a unique pulmonary aspergillosis manifestation with predominantly bronchocentric granulomas.
- Absence of eosinophilia and immunoglobulin deposition suggests a non-allergic pathway in this patient.
- Successful treatment with the antifungal drug 5-flucytosine was achieved.
Implications:
- This case expands the clinical spectrum of pulmonary aspergillosis, particularly in non-immunocompromised individuals.
- It suggests that bronchocentric granulomas can be a primary manifestation of Aspergillus infection, even without allergic indicators.
- Further research may be needed to understand the pathogenesis and diagnostic criteria for such presentations.