Unusual manifestations of pulmonary aspergillosis.

Pulmonary aspergillosis is being diagnosed with increasing frequency, particularly in larger referral centers. The spectrum of lung pathology can be classified into 3 major groups: A) non-invasive mycetoma; B) allergic bronchopulmonary aspergillosis and C) invasive aspergillosis. Five patients with pulmonary aspergillosis are presented, illustrating unusual features of each major group. Transthoracic needle aspiration biopsy was diagnostic in 3 patients. It is important to differentiate a mycetoma developing in a pre-existing cavity from a cavitating Aspergillus abscess. The radiologic appearances may be similar, but evolution of the 2 lesions is entirely different.