Farley M L, Mabry L, Muñoz L A, Diserens H W
Acta Cytol. 1985 Sep-Oct;29(5):737-44.
Birefringent needlelike crystals in rosette or wheat-sheaf-like arrangements were found in pulmonary cytology specimens from 11 of 65 patients who had either sputum cultures positive for Aspergillus or histologically confirmed pulmonary aspergilloma. No crystals were found in specimens from 60 control patients with and without known fungal disease. The crystals were most often associated with A. niger infection (45.4%), followed by A. flavus (16%). Crystals were also observed in one case of A. fumigatus infection and in one case in which the species was not determined. In two cases, crystals were found more than one year before sputum cultures became positive; in one of these patients, a fungus ball was not identified by X ray until five years after the first appearance of the crystals in the sputum. Sixty-four percent of the patients with crystals also showed moderate to severe cytologic atypia. The crystals are thought to be calcium oxalate. We conclude that the presence of birefringent needlelike crystals with rosette or wheat-sheaf-like arrangements in pulmonary cytology specimens is a reliable marker for the presence of Aspergillus infection, which may be detected before cultures are positive or a fungus ball is evident on X ray.
在65例痰培养曲霉菌阳性或经组织学确诊为肺曲菌球的患者中，有11例患者的肺细胞学标本中发现了呈玫瑰花结或麦秸样排列的双折射针状晶体。60例已知或未知真菌病的对照患者的标本中未发现晶体。这些晶体最常与黑曲霉感染相关（45.4%），其次是黄曲霉（16%）。在1例烟曲霉感染病例和1例未确定菌种的病例中也观察到了晶体。在2例病例中，在痰培养阳性一年多以前就发现了晶体；其中1例患者，直到痰液中首次出现晶体五年后，X线检查才发现真菌球。64%有晶体的患者还表现出中度至重度细胞学异型性。这些晶体被认为是草酸钙。我们得出结论，肺细胞学标本中出现呈玫瑰花结或麦秸样排列的双折射针状晶体是曲霉菌感染的可靠标志物，在培养阳性或X线显示真菌球之前即可检测到。
