Plugging of airways with mucus - Aspergillus and Aspergillosis

Date: 3 February 2014

A. Necrotic mass prolapsing in and out of the distal right intermediate bronchus obscuring both the basal stem and basal division

Notes:

Initially it was incorrectly diagnosed as a bronchial carcinoma.
The material was allergic mucin with mucus and cellular debris arranged in a layered pattern. Cellular debris was almost entirely eosinophils with scattered Charcot-Leyden crystals. A Grocott stain showed multiple branching fungal hyphae, consistent with Aspergillus spp. Subsequently her total IgE rose to 750 KIU/L and Aspergillus specific RAST to 14.9 KUa/L.