A Case Series of Chronic Necrotizing Pulmonary Aspergillosis and a New Proposal A Case Series of Chronic Necrotizing Pulmonary Aspergillosis and a New Proposal

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Author(s)

    • Nagayasu Takeshi
    • Department of Translational Medical Science, Nagasaki University Graduate School of Biomedical Sciences
    • Kohno Shigeru
    • Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences
    • Izumikawa Koichi
    • Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences
    • Tashiro Masato
    • Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences
    • Morinaga Yoshitomo
    • Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
    • Nakamura Shigeki
    • Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences
    • Imamura Yoshifumi
    • Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences
    • Miyazaki Taiga
    • Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences
    • Kakeya Hiroshi
    • Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences
    • Yamamoto Yoshihiro
    • Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences

Abstract

Chronic necrotizing pulmonary aspergillosis (CNPA) is an indolent, cavitating process in the lungs resulting from invasion of lung tissue by <i>Aspergillus</i> spp. However, most previous reports have not found any clear evidence of parenchymal invasion, and clinical distinction between CNPA and chronic cavitary pulmonary aspergillosis (CCPA) is difficult. We performed a histopathological study of lung specimens obtained by autopsy, surgical resection, or biopsy to clarify the characteristic pathological and clinical features of CNPA. We present 4 cases of proven CNPA, diagnosed by histological demonstration of tissue invasion by the fungus, and present its clinical features. These 4 patients were male, and the mean age was 62 years (range, 51–75 years). Their underlying conditions were chronic obstructive pulmonary disease (<i>n</i> = 3), sequelae of pulmonary tuberculosis (<i>n</i> = 2), and diabetes mellitus (<i>n</i> = 1). <i>Aspergillus</i> precipitation tests were positive for 3; and <i>Aspergillus</i> antigen tests were positive for 2 on admission, and subsequently, for all 4. The isolated pathogens were <i>Aspergillus niger</i> for 1 and <i>A. fumigatus</i> for 1. Initial radiographic findings were infiltrates or nodular lesions, which slowly progressed and cavitated before the appearance of fungus balls. Although CNPA has characteristic pathological features, it is clinically difficult to distinguish CNPA from CCPA. We propose to use the term chronic progressive pulmonary aspergillosis for both CNPA and CCPA.

Journal

  • Japanese Journal of Infectious Diseases

    Japanese Journal of Infectious Diseases 66(4), 312-316, 2013

    National Institute of Infectious Diseases, Japanese Journal of Infectious Diseases Editorial Committee

Codes

  • NII Article ID (NAID)
    130003381694
  • NII NACSIS-CAT ID (NCID)
    AA1132885X
  • Text Lang
    ENG
  • Article Type
    journal article
  • ISSN
    1344-6304
  • NDL Article ID
    024716428
  • NDL Call No.
    Z53-C450
  • Data Source
    NDL  IR  J-STAGE 
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