曲霉菌病的流行病学及诊治五院讲课讲解课件.ppt

* Aspergilloma in a 54-year-old man with a history of tuberculosis. (a) Linear tomogram (magni- fied view) shows multiple fungus balls within a cavity in the right upper lobe. (b) Photograph of the corresponding gross surgical specimen demonstrates multiple irregular fungus balls virtually filling the pulmonary cavity. * Left. Bilateral aspergillomas in a 71-year-old man with residual tuberculosis. Chest computed tomographic (CT) scan (lung window) shows large cavities bilaterally in the upper lobes containing fungus balls of different sizes. Right. Aspergilloma with the air crescent sign in a 67-year-old woman with residual tuberculosis. Thinsection CT scan (mediastinal window) shows extensive scarring in the upper lobes. A large aspergilloma is seen in the left upper lobe, with a characteristic air crescent between the aspergilloma and the cavity wall. Note the marked pleural thickening surrounding the cavity containing the aspergilloma (arrowheads). Punctate bilateral pleural calcifications are also visible. * Figure 8. Allergic bronchopulmonary aspergillosis in a 43-year-old asthmatic man. (a, b) Thin-section CT scans (b obtained at a lower level than a) show multiple tubular areas of increased attenuation in the left upper lobe. (c) Photomicrograph demonstrates mucous plugs composed of mucin. (d) Photomicrograph (original magnification, 100; Grocot silver stain) clearly shows multiple fungal hyphae. (e) On a CT scan obtained 2 months later, cystic bronchiectasis is clearly depicted. * Figure 9. Semi-invasive aspergillosis in a 68-year-old man with chronic bronchitis and recurrent episodes of mild hemoptysis. (a) Thin-section CT scan (lung window) shows bilateral rounded areas of consolidation with associated cavitation in both upper lobes. (b) Photograph of an autopsy specimen from the left upper lobe shows an irregular cavitary lesion with regular margins and a dark brown appearance caused by necrotic material and Aspergillus infection. * Figure 11. Necro