Initial computed tomography findings of invasive pulmonary aspergillosis in non-hematological patients

The computed tomography (CT) findings of invasive pulmonary aspergillosis (IPA) are unclear in non-hematological patients. The present study was a retrospective evaluation of CT images in non-hematological patients with IPA.

All adult patients who met the 2008 European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria for proven or probable IPA were included during a 5-year study at our institutions. Initial CT findings in our cohort were retrospectively reviewed by two independent thoracic radiologists blinded to patient demographics and clinical outcomes. The presence, pattern, and distribution of abnormalities were recorded.

Twenty-three non-hematological patients with pathologically confirmed IPA were included in our study. Areas of ground-glass opacities were present in 14 patients (61%), which were bilateral in 10 patients and unilateral in four. This pattern mainly involved the middle and upper lung zones. Air-space consolidation was identified in 12 patients (52%), and the areas were distributed along the bronchus or subpleura in most cases. Other findings, including five small nodules (22%), three macronodules (13%), and one halo sign (4%), were less common.

CT findings of IPA in non-hematological patients frequently manifested as acute bronchopneumonia, and ground-glass opacities and air-space consolidations were the most common CT findings of IPA in these patients.