Airway invasive aspergillosis
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Airway invasive aspergillosis refers to a form of invasive aspergillosis.
Epidemiology
It usually occurs in immunocompromised neutropenic patients and in patients with AIDS. Aspergillosis affecting the airways as the major or only feature of invasive disease is uncommon and is thought to occur only around 7% of cases of intrathoracic aspergillosis 3.
Clinical presentation
Clinical manifestations can vary and can range from an acute tracheobronchitis, to bronchiolitis to bronchopneumonia.
Pathology
It is histologically characterized by the presence of Aspergillus organisms deep to the airway basement membrane 1.
Two morphological forms of invasive aspergillosis of the trachea and bronchi have been described 3
- intraluminal
- circumferential: circumferential and superficial “pseudomembrane” of necrotic tissue, fibrin and hyphae, which may result in airway occlusion - multiple nodular plaques
- invades: invades adjacent tissues and may result in broncho-oesophageal and fatal haemorrhage from bronchoarterial fistulation
Radiographic features
HRCT Chest
Imaging spectrum can vary dependent on whether is it an obstructive tracheobronchitis, bronchiolitis or bronchopneumonia
-
obstructive tracheobronchitis due to aspergillosis
- most have normal radiographic findings in the acute phase
- occasionally, tracheal or bronchial wall thickening may be seen
-
aspergillus bronchiolitis
- usually seen as centrilobular nodules and branching linear or nodular areas of increased attenuation having a “tree-in-bud” appearance
- the centrilobular nodules have a patchy distribution in the lung.
-
aspergillus bronchopneumonia
- typically seen as predominantly peribronchial areas of consolidation
- rarely, there can be lobar consolidation
- it is almost impossible to differentiate a aspergillus bronchopneumonia from bronchopneumonia of other causes
See also
-<p><strong>Airway invasive aspergillosis</strong> refers to a form of <a href="/articles/invasive-aspergillosis" title="invasive aspergillosis">invasive aspergillosis</a>. </p><h4>Epidemiology</h4><p>It usually occurs in immunocompromised neutropenic patients and in patients with <a href="/articles/hiv-aids-1" title="Acquired immunodeficiency syndrome (AIDS)">AIDS</a>. Aspergillosis affecting the airways as the major or only feature of invasive disease is uncommon and is thought to occur only around 7% of cases of intrathoracic aspergillosis<sup> 3</sup>.</p><h4>Clinical presentation</h4><p>Clinical manifestations can vary and can range from an acute tracheobronchitis, to bronchiolitis to bronchopneumonia.</p><h4>Pathology</h4><p>It is histologically characterized by the presence of <em style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; outline-style: none; font-style: italic; font-size: inherit; font-family: inherit; line-height: inherit; vertical-align: baseline; "><a href="/articles/aspergillus" title="Aspergillus">Aspergillus</a></em> organisms deep to the airway basement membrane <sup>1</sup>. </p><p>Two morphological forms of invasive aspergillosis of the trachea and bronchi have been described <sup>3</sup></p><ul>-<li>intraluminal - circumferential and superficial “pseudomembrane” of necrotic tissue, fibrin and hyphae, which may result in airway occlusion</li>-<li>multiple nodular plaques - invades adjacent tissues and may result in broncho-oesophageal and fatal haemorrhage from <a href="/articles/bronchoarterial-fistula" title="bronchoarterial fistula">bronchoarterial fistulation</a>-</li>- +<p><strong>Airway invasive aspergillosis</strong> refers to a form of <a href="/articles/invasive-aspergillosis">invasive aspergillosis</a>. </p><h4>Epidemiology</h4><p>It usually occurs in immunocompromised neutropenic patients and in patients with <a href="/articles/hivaids">AIDS</a>. Aspergillosis affecting the airways as the major or only feature of invasive disease is uncommon and is thought to occur only around 7% of cases of intrathoracic aspergillosis<sup> 3</sup>.</p><h4>Clinical presentation</h4><p>Clinical manifestations can vary and can range from an acute tracheobronchitis, to bronchiolitis to bronchopneumonia.</p><h4>Pathology</h4><p>It is histologically characterized by the presence of <em><a href="/articles/aspergillus">Aspergillus</a></em> organisms deep to the airway basement membrane <sup>1</sup>. </p><p>Two morphological forms of invasive aspergillosis of the trachea and bronchi have been described <sup>3</sup></p><ul>
- +<li>intraluminal: circumferential and superficial “pseudomembrane” of necrotic tissue, fibrin and hyphae, which may result in airway occlusion</li>
- +<li>multiple nodular plaques: invades adjacent tissues and may result in broncho-oesophageal and fatal haemorrhage from <a href="/articles/bronchoarterial-fistula">bronchoarterial fistulation</a>
- +</li>
-<li>-<a href="/articles/obstructive-tracheobronchitis-due-to-aspergillosis" title="obstructive tracheobronchitis due to aspergillosis ">obstructive tracheobronchitis due to aspergillosis </a><ul>-<li>most have normal radiographic findings in the acute phase</li>-<li>occasionally, tracheal or bronchial wall thickening may be seen</li>- +<li>
- +<a href="/articles/obstructive-tracheobronchitis-due-to-aspergillosis">obstructive tracheobronchitis due to aspergillosis </a><ul>
- +<li>most have normal radiographic findings in the acute phase</li>
- +<li>occasionally, tracheal or bronchial wall thickening may be seen</li>
-</li>-<li>-<a href="/articles/aspergillus-bronchiolitis" title="aspergillus bronchiolitis">aspergillus bronchiolitis</a> <ul>-<li>usually seen as <a href="/articles/centrilobular-lung-nodules-1" title="centrilobular nodules">centrilobular nodules</a> and branching linear or nodular areas of increased attenuation having a “<a href="/articles/tree-in-bud-sign-3" title="Tree-in-Bud Sign">tree-in-bud</a>” appearance </li>-<li>the centrilobular nodules have a patchy distribution in the lung. </li>- +</li>
- +<li>
- +<a href="/articles/aspergillus-bronchiolitis">aspergillus bronchiolitis</a> <ul>
- +<li>usually seen as <a href="/articles/centrilobular-lung-nodules-1">centrilobular nodules</a> and branching linear or nodular areas of increased attenuation having a “<a href="/articles/tree-in-bud-sign-3">tree-in-bud</a>” appearance </li>
- +<li>the centrilobular nodules have a patchy distribution in the lung. </li>
-</li>-<li>-<a href="/articles/aspergillus-bronchopneumonia" title="aspergillus bronchopneumonia ">aspergillus bronchopneumonia </a><ul>-<li>typically seen as predominantly peribronchial areas of consolidation</li>-<li>rarely, there can be <a href="/articles/lobar-consolidation" title="lobar consolidation">lobar consolidation</a>-</li>-<li>it is almost impossible to differentiate a aspergillus bronchopneumonia from bronchopneumonia of other causes</li>- +</li>
- +<li>
- +<a href="/articles/aspergillus-bronchopneumonia">aspergillus bronchopneumonia </a><ul>
- +<li>typically seen as predominantly peribronchial areas of consolidation</li>
- +<li>rarely, there can be <a href="/articles/lobar-consolidation">lobar consolidation</a>
- +</li>
- +<li>it is almost impossible to differentiate a aspergillus bronchopneumonia from bronchopneumonia of other causes</li>
-</li>--</ul><h4>See also</h4><ul><li><a href="/articles/pulmonary-aspergillosis" title="Aspergillosis">aspergillosis</a></li></ul>- +</li>
- +</ul><h4>See also</h4><ul><li><a href="/articles/pulmonary-aspergillosis">aspergillosis</a></li></ul>
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