Invasive aspergillosis of the airways: radiographic, CT, and pathologic findings.

Abstract

To assess the radiographic, computed tomographic (CT), and pathologic findings in invasive aspergillosis of the airways. The study included nine consecutive patients (aged 17-65 years [median, 49 years]) with pathologically proved invasive aspergillosis of the airways. All nine underwent chest radiography and seven underwent CT within 3 days of diagnosis. The radiographic findings include normal parenchyma (n = 1), unilateral consolidation (n = 1), bilateral consolidation (n = 5), and ill-defined nodules (n = 2). The main findings at CT included lobar consolidation (n = 1), bilateral predominantly peribronchial consolidation (n = 3), ground-glass attenuation (n = 1), and centrilobular nodules less than 5 mm in diameter (n = 2). At pathologic examination, the peribronchial infiltrates represented bronchopneumonia and the nodules represented Aspergillus bronchiolitis with a variable degree of peribronchiolar organizing pneumonia and hemorrhage. Radiographic findings of invasive aspergillosis of the airways consist of consolidation or ill-defined nodules. At CT, the consolidation can be seen to be peribronchial and the nodules centrilobular.