Chronic necrotizing pulmonary aspergillosis
2011
Introduction. Chronic necrotizing pulmonary aspergillosis (CNPA) is a
cavitary, infectious process of lung parenchyma with slow progressive course.
Vascular invasion and dissemination to other organs are unusual. Case report.
We presented a 25-year old man with bilineal acute leukaemia who developed
pulmonary and systemic symptoms. Chest CT showed nodular consolidations and
cavitary lesions in both lungs. Bronchial biopsy revealed necrotic hyphae but
it was negative for Aspergillus by culture. Serum was positive for antibodies
to Aspergillus, but it was negative for antigens. A thoracoscopic lung biopsy
of the upper left lobe revealed necrosis of lung tissue, with acute and
chronic inflammation of the cavity wall and the presence of hyphae consistent
with Aspergillus species. Conclusion. Although confirmation of the diagnosis
is difficult, a combination of characteristic clinical, radiological and
histological findings and either serological results positive for Aspergillus
or the isolation of Aspergillus from respiratory samples are highly
indicative of CNPA.
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