Conidial heads (Fruiting Bodies) as a hallmark for histopathological diagnosis of angioinvasive aspergillosis

Authors

  • Luciana Depiere Lanzarin University of São Paulo. Faculty of Medicine. Pathology Department
  • Livia Caroline Barbosa Mariano University of São Paulo. Faculty of Medicine. Hospital das Clínicas. Hematopoietic Stem Cell Transplantation Division
  • Maria Cristina Martins de Almeida Macedo University of São Paulo. Faculty of Medicine. Hospital das Clínicas. Hematopoietic Stem Cell Transplantation Division
  • Marjorie Vieira Batista University of São Paulo. Faculty of Medicine. Hospital das Clínicas. Hematopoietic Stem Cell Transplantation Division - University of São Paulo. Faculty of Medicine. Hospital das Clínicas. Infectious and Parasitic Diseases Department
  • Amaro Nunes Duarte Neto University of São Paulo. Faculty of Medicine. Pathology Department - University of São Paulo. Faculty of Medicine. Hospital das Clínicas. Emergency Department

DOI:

https://doi.org/10.4322/acr.2015.025

Keywords:

Aspergillus, Neutropenia, Hematopoietic Stem Cell Transplantation, Autopsy

Abstract

Aspergillosis is a mycosis that afflicts immunocompetent and immunocompromised hosts; among the former it exhibits different clinical pictures, and among the latter the infection renders an invasive form of the disease. The histologic diagnosis of invasive aspergillosis is somewhat challenging mostly because of some morphological similarities between other fungi. However, when present, the conidial heads are pathognomonic of aspergillosis. The authors present the case of a 68-year-old woman who was submitted to autologous hematopoietic stem cell transplantation in the pursuit of multiple myeloma treatment. The post-transplantation period was troublesome with the development of severe neutropenia, human respiratory syncytial virus pneumonia, and disseminated aspergillosis, which was suspected because of a positive serum galactomannan antigen determination, and resulted in a fatal outcome. The autopsy findings showed diffuse alveolar damage associated with angioinvasive pulmonary aspergillosis with numerous hyphae and conidial heads in the lung parenchyma histology. The authors call attention to the aid of autopsy in confirming the diagnosis of this deep mycosis, since only the research of the galactomannan antigen may be insufficient and uncertain due to its specificity and of the possibility of false-positive results

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Published

2015-12-10

How to Cite

Lanzarin, L. D., Mariano, L. C. B., Macedo, M. C. M. de A., Batista, M. V., & Duarte Neto, A. N. (2015). Conidial heads (Fruiting Bodies) as a hallmark for histopathological diagnosis of angioinvasive aspergillosis. Autopsy and Case Reports, 5(4), 9-18. https://doi.org/10.4322/acr.2015.025

Issue

Section

Article / Autopsy Case Report