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Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
09:52

Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis

Published on: March 9, 2018

Crystals occurring in pulmonary cytology specimens. Association with Aspergillus infection

M L Farley, L Mabry, L A Muñoz

    Acta Cytologica
    |September 1, 1985
    PubMed

    Insights

    Birefringent needlelike crystals in pulmonary cytology may indicate Aspergillus infection, appearing before positive cultures or X-ray evidence. These crystals, likely calcium oxalate, serve as a reliable diagnostic marker for fungal disease.

    Area of Science:

    • Pulmonary Cytopathology
    • Mycology
    • Medical Diagnostics

    Background:

    • Pulmonary aspergillosis is a significant fungal infection.
    • Early detection of Aspergillus infection is crucial for patient outcomes.
    • Diagnostic challenges exist in identifying fungal elements in cytology specimens.

    Purpose of the Study:

    • To evaluate the diagnostic significance of birefringent needlelike crystals in pulmonary cytology.
    • To determine the association of these crystals with Aspergillus infection.
    • To assess the crystals' potential as an early marker for pulmonary aspergillosis.

    Main Methods:

    • Analysis of pulmonary cytology specimens from patients with and without Aspergillus infection.
    • Identification and characterization of birefringent needlelike crystals.
    • Correlation of crystal presence with sputum cultures, histology, and radiographic findings.
    • Assessment of cytologic atypia in patients with crystals.

    Main Results:

    • Birefringent needlelike crystals in rosette/wheat-sheaf arrangements were found in 11/65 patients with confirmed Aspergillus infection.
    • No crystals were observed in 60 control patients.
    • Crystals were most associated with Aspergillus niger (45.4%) and Aspergillus flavus (16%).
    • In two cases, crystals preceded positive sputum cultures by over a year, and in one case, by five years before X-ray detection of a fungus ball.
    • Sixty-four percent of patients with crystals showed moderate to severe cytologic atypia.

    Conclusions:

    • Birefringent needlelike crystals in pulmonary cytology are a reliable marker for Aspergillus infection.
    • These crystals may serve as an early diagnostic indicator, preceding culture positivity or radiographic evidence.
    • The crystals are likely calcium oxalate and may be associated with cytologic atypia.

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