Subacute Invasive (Chronic Necrotising) Pulmonary Aspergillosis

Date: 26 November 2013

  • CPNADUT

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Case of CNPA

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Showing 10 posts of 2574 posts found.

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  • IPA in leukaemia (B)

    25/04/90 After itraconazole treatment. Major improvement, defined as a complete response, after 10 weeks therapy with itraconazole.

    Image B. Pt TH 25/04/90

  • IPA in leukaemia (A)

    5/2/90 Before itraconazole therapy

    Image A. Pt TH 05/02/90

  • Invasive aspergillosis with leukaemia

    Image A. Chest x-ray shows a single nodule in the left mid lung field.

    Image B. This emphasises how chest x-rays in this context underestimate the extent of disease. The most anterior nodule has ground glass surrrounding the nodule, a halo sign. This diagnostic feature is missed on plain chest X-rays.

    Image A. Chest x-ray shows a single nodule in the left mid lung, Image B. The thoracic CT scan done a day later shows 3 nodules in the left lung.

  • IPA in lymphoma

    Chest X ray after 4 days, prior to treatment, showing massive increase in volume of lesion (Fig 2)

    Chest X ray after 4 days, prior to treatment

  • PT JA Diffuse bitateral nodular IPA in AIDS and CMV. Eye and gastric lesions.

    Image A. This patient, aged 25 years developed a non productive cough and dyspnoea in the context of late-stage AIDS, CMV disease with ganciclovir-induced neutropenia and receiving corticosteroids. His chest radiograph shows fine bilateral reticular lower-lobe shadowing. He then developed gastro-intestinal bleeding with a gastric ulcer which showed hyphae on biopsy. He then developed blindness of one eye and the globe of his eye perforated. Hyphae were seen and Aspergillus cultured from the vitreous aspirate.

    Image B. This radiograph, taken 25 days after the first and 3 days before death, shows of fine bilateral lower-lobe reticular shadows progressing to nodules in all lung zones.

    This patient was reported as patient 3 in Denning DW, Follansbee S, Scolaro M, Norris S, Edelstein D, Stevens DA. Pulmonary aspergillosis in the acquired immunodeficiency syndrome. N Engl J Med 1991; 324: 654-662.

    Image A. Diffuse bilateral IPA in AIDS, pt JA, Image B. Diffuse bilateral nodular IPA in AIDS, pt JA

  • Pt RR IPA in leukaemia, positive aspergillus culture

    Further details

    Image A. Bronchoscopy revealed Aspergillus on culture. 

    Image B. The ability of Aspergillus to cause pulmonary infarction, probably through direct angioinvasion in this case, is characteristic. 

    Image A. Chest radiograph of a leukaemic man showing an area of consolidation at the left base, abutting on the pleura and some faint soft shadowing at the right apex. , Lung perfusion scan, pt RR Technetium perfusion scan of the lungs showing left lower lobe and right upper zone defects, matching the radiological areas of abnormality.

  • IPA in Bone Marrow Transplant

    IPA in BMT, Pt NM

    Chest radiograph showing a new cavitary lesion

  • IPA in lymphoma

    (Fig 1) Chest radiograph with ‘classical’ appearance of a pulmonary infarction – a wedge-shaped lesion peripherally set against the pleura.

    Chest radiograph with 'classical' appearance of a pulmonary infarction

  • IPA in leukaemia, Pt DW

    Large soft left upper-lobe shadow of focal invasive pulmonary aspergillosis in leukaemia, that was missed on earlier radiographs but apparent retrospectively. Variable density of the lesion suggests cavitation, which would be clearly visible on a CT scan of the thorax.

    1ipa6

  • IPA in leukaemia H

    Severe unilateral invasive aspergillosis of the left lung, with complete consolidation of the left lower-lobe and reticular shadowing extending up into the left upper lobe. The right lung appears normal.

    Severe unilateral invasive aspergillosis of the left lung