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Pathologic features of allergic bronchopulmonary aspergillosis
C H Bosken1, J L Myers, P A Greenberger
1Department of Pathology, University of Alabama, Birmingham.
The American Journal of Surgical Pathology
|March 1, 1988
Summary
Allergic bronchopulmonary aspergillosis (ABPA) is characterized by bronchocentric granulomatosis (BCG) or mucoid impaction of bronchi (MIB). These findings, along with eosinophilia and fungal hyphae, are key diagnostic indicators.
Area of Science:
- Pulmonary Pathology
- Allergic Diseases
- Medical Mycology
Background:
- Allergic bronchopulmonary aspergillosis (ABPA) is an inflammatory lung disease.
- Accurate diagnosis relies on identifying characteristic pathological features.
Purpose of the Study:
- To detail the histopathological findings in surgically resected lung tissue from ABPA patients.
- To correlate these findings with the diagnosis of ABPA.
Main Methods:
- Analysis of 18 surgically excised lung tissue specimens from patients with ABPA.
- Microscopic examination for granulomas, mucus impaction, inflammation, eosinophils, Charcot-Leyden crystals, and fungal elements.
Main Results:
- Bronchocentric granulomatosis (BCG) and/or mucoid impaction of bronchi (MIB) were present in all cases.
- Impacted mucin contained eosinophils and Charcot-Leyden crystals.
- Exudative bronchiolitis, eosinophilic pneumonia, and noninvasive fungal hyphae were frequently observed.
Conclusions:
- The presence of BCG or MIB, particularly with tissue eosinophilia, strongly suggests ABPA.
- Combined findings of BCG/MIB, eosinophilia, and fungal hyphae are diagnostic of ABPA or related allergic fungal reactions.