Generalized aspergillosis showing a granulomatous pattern.

An autopsy case of a very rare form of generalized aspergillosis with a prominent granulomatous pattern simulating sarcoidosis was presented. The patient was a forty-year-old Japanese female with a four years' clinical course. Kveim's test was positive. Multiple epithelioid cell granulomata as well as necrotizing and suppurative lesions were recognized in generalized lymph nodes, liver, epicardium, gall bladder, adrenals, kidneys and duodenal mucosa. Fungal elements in the epithelioid cell granulomata and necrotizing lesions were identified as Aspergillus by fluorescent antibody technique (indirect method). Predisposing factors for the generalized fungal infection could not be clarified in this case. There was neither underlying disease nor evident immunodeficiency state, so far as examined.