24485              ASPERGILLOSIS OF THE LUNG

This 65 year old man presented with a 2 week history of anorexia, weakness, diarrhoea, shortness of breath and increasing sputum.  He had signs of widespread bronchopneumonia.  Culture grew Haemophilus and then Klebsiella.  He died despite therapy.

Section through the right lung shows a large area of infarction involving the apex of the upper lobe, delineated by a wavy line of white tissue.  At postmortem this area was dry and dusty and contained a grey branching fungus proven to be aspergillus.  The rest of the upper lobe shows consolidation.  The middle and lower lobes are oedematous and show patchy areas of consolidation.  Histology shows diffuse organising fibrinous pneumonia with focal suppuration.  Some of the abscesses contain masses of branching fungal hyphae.  Some arteries are acutely thrombosed, apparently as a result of the inflammatory process.  There is no evidence of acute specific allergic arteritis either in the lung or other organs.