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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
Invasive pulmonary aspergillosis
Definitions
Infection caused by saprophytic and ubiquitous airborne filamentous fungus Aspergillus species (usually Aspergillus fumigatus)
Other species: Aspergillus flavus, Aspergillus niger
Affects almost exclusively immunocompromised patients with severe neutropenia: Absolute neutrophil count < 500 per μL
Angioinvasive aspergillosis
Most common form of invasive aspergillosis
Occlusion of small to medium-sized pulmonary arteries by fungal hyphae
Wedge-shaped subpleural consolidation corresponding to hemorrhagic infarct
Airway-invasive aspergillosis
Rare form of invasive aspergillosis
Fungal hyphae beyond airway basement membrane
IMAGING
General Features
Radiographic Findings
CT Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Prasad A et al: Pulmonary aspergillosis: what CT can offer before it is too late! J Clin Diagn Res. 10(4):TE01-5, 2016
Chabi ML et al: Pulmonary aspergillosis. Diagn Interv Imaging. 96(5):435-42, 2015
Stanzani M et al: High resolution computed tomography angiography improves the radiographic diagnosis of invasive mold disease in patients with hematological malignancies. Clin Infect Dis. 60(11):1603-10, 2015
Walsh S et al: Importance of the reversed halo sign for the diagnosis of angioinvasive pulmonary aspergillosis. Respir Med. 108(8):1240, 2014
Xu XY et al: Diagnosis of airway-invasive pulmonary aspergillosis by tree-in-bud sign in an immunocompetent patient: case report and literature review. J Mycol Med. 23(1):64-9, 2013
Georgiadou SP et al: The diagnostic value of halo and reversed halo signs for invasive mold infections in compromised hosts. Clin Infect Dis. 52(9):1144-55, 2011
Greene RE et al: Imaging findings in acute invasive pulmonary aspergillosis: clinical significance of the halo sign. Clin Infect Dis. 44(3):373-9, 2007
Althoff Souza C et al: Pulmonary invasive aspergillosis and candidiasis in immunocompromised patients: a comparative study of the high-resolution CT findings. J Thorac Imaging. 21(3):184-9, 2006
Horger M et al: Invasive pulmonary aspergillosis: frequency and meaning of the "hypodense sign" on unenhanced CT. Br J Radiol. 78(932):697-703, 2005
Franquet T et al: Spectrum of pulmonary aspergillosis: histologic, clinical, and radiologic findings. Radiographics. 21(4):825-37, 2001
Primack SL et al: Pulmonary nodules and the CT halo sign. Radiology. 190(2):513-5, 1994
Kuhlman JE et al: Invasive pulmonary aspergillosis in acute leukemia. The contribution of CT to early diagnosis and aggressive management. Chest. 92(1):95-9, 1987
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
Invasive pulmonary aspergillosis
Definitions
Infection caused by saprophytic and ubiquitous airborne filamentous fungus Aspergillus species (usually Aspergillus fumigatus)
Other species: Aspergillus flavus, Aspergillus niger
Affects almost exclusively immunocompromised patients with severe neutropenia: Absolute neutrophil count < 500 per μL
Angioinvasive aspergillosis
Most common form of invasive aspergillosis
Occlusion of small to medium-sized pulmonary arteries by fungal hyphae
Wedge-shaped subpleural consolidation corresponding to hemorrhagic infarct
Airway-invasive aspergillosis
Rare form of invasive aspergillosis
Fungal hyphae beyond airway basement membrane
IMAGING
General Features
Radiographic Findings
CT Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Prasad A et al: Pulmonary aspergillosis: what CT can offer before it is too late! J Clin Diagn Res. 10(4):TE01-5, 2016
Chabi ML et al: Pulmonary aspergillosis. Diagn Interv Imaging. 96(5):435-42, 2015
Stanzani M et al: High resolution computed tomography angiography improves the radiographic diagnosis of invasive mold disease in patients with hematological malignancies. Clin Infect Dis. 60(11):1603-10, 2015
Walsh S et al: Importance of the reversed halo sign for the diagnosis of angioinvasive pulmonary aspergillosis. Respir Med. 108(8):1240, 2014
Xu XY et al: Diagnosis of airway-invasive pulmonary aspergillosis by tree-in-bud sign in an immunocompetent patient: case report and literature review. J Mycol Med. 23(1):64-9, 2013
Georgiadou SP et al: The diagnostic value of halo and reversed halo signs for invasive mold infections in compromised hosts. Clin Infect Dis. 52(9):1144-55, 2011
Greene RE et al: Imaging findings in acute invasive pulmonary aspergillosis: clinical significance of the halo sign. Clin Infect Dis. 44(3):373-9, 2007
Althoff Souza C et al: Pulmonary invasive aspergillosis and candidiasis in immunocompromised patients: a comparative study of the high-resolution CT findings. J Thorac Imaging. 21(3):184-9, 2006
Horger M et al: Invasive pulmonary aspergillosis: frequency and meaning of the "hypodense sign" on unenhanced CT. Br J Radiol. 78(932):697-703, 2005
Franquet T et al: Spectrum of pulmonary aspergillosis: histologic, clinical, and radiologic findings. Radiographics. 21(4):825-37, 2001
Primack SL et al: Pulmonary nodules and the CT halo sign. Radiology. 190(2):513-5, 1994
Kuhlman JE et al: Invasive pulmonary aspergillosis in acute leukemia. The contribution of CT to early diagnosis and aggressive management. Chest. 92(1):95-9, 1987
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