Subacute Invasive (Chronic Necrotising) Pulmonary Aspergillosis

Date: 26 November 2013

Case of CNPA

Copyright: n/a

Notes: n/a


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  • Light microscopic image of hyphae in an aspergilloma (10x magnification)

    IPA microscopy 3

  • Light microscopic image of hyphae in an aspergilloma (400x magnification)

    IPA microscopy 2

  • An aspergilloma (or fungal ball) is a mass of fungus found inside the body, for example inside cavities such as the lungs or sinuses, or as abscesses in organs such as the brain or kidney. They are made up of threadlike fungal strands (hyphae) that are densely packed but only around 1/200 of a millimetre in diameter. A mass of hyphae is called a mycelium.

    In this image, a slice through an aspergilloma has been imaged using a transmission electron microscope.

    IPA microscopy 1

  • Aspergillus can punch through the lining of the lungs and invade the blood vessels below, in a process called angioinvasion. It can result in blockage (occlusion) of the blood vessel and damage to the local tissue through lack of oxygen (infarction). In severely immunocompromised patients, fragments can even break off and travel to other organs in the body.

    In this image, a tissue section through a blocked blood vessel has been stained with the dyes haematoxylin (purple, binds DNA) and eosin (pink, binds proteins).

    Read more about Aspergillus angioinvasion

    Read more about H&E staining

    blood vessel invasion

  • Showing the edge of a colony of aspergillus forming a fungal ball. The fungal hyphae exhibit dichotomous 45 degree angle branching and septae typical of Aspergillus.

    fungal ball

  • Pt CJ finger clubbing, this patient had chronic cavitary pulmonary aspergillosis, with an aspergilloma since 1988, following an episode of haemoptysis. Currently patient still has symptomatic disease.

    Images E,F Blood stained sputum samples from this patient.

    Image F., Image E., Image A., Image B., Image C., Image D.

  • Disseminated, invasive aspergillosis showing dichotomously branching hyphae. Original magnification x300. Stained with Gomori Methenamine Silver (GMS).

    Skeletal muscle - invasive aspergillosis showing dichotomously branching hyphae x300

  • Disseminated, invasive aspergillosis showing dichotomously branching hyphae. Original magnification x150. Stained with Gomori Methenamine Silver (GMS).

    Skeletal muscle - invasive aspergillosis showing dichotomously branching hyphae x100

  • Disseminated, invasive aspergillosis showing dichotomously branching hyphae. Original magnification x50. Stained with Gomori Methenamine Silver (GMS).

    Skeletal muscle - invasive aspergillosis showing dichotomously branching hyphae

  • Light microscopical appearance of invasive pulmonary aspergillosis showing vessel occlusion with thrombus and distal infarction (Haematoxylin and eosin, x100)

    Invasive pulmonary aspergillosis.