Procop G W, Johnston W W
Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA.
Diagn Cytopathol. 1997 Oct;17(4):292-4. doi: 10.1002/(sici)1097-0339(199710)17:4<292::aid-dc10>3.0.co;2-j.
Bronchoalveolar lavage (BAL) material is commonly received in cytopathology for the exclusion of microorganisms. When crystalline material suggestive of calcium oxalate is present in the specimen, a search for fungal elements should be undertaken. Aspergillus niger is the hyaline mold associated with the presence of oxalate crystals. Commonly fragments of hyphae and occasionally entire conidiophores may be present in BAL specimens from patients with aspergillosis. We report a case of a patient with saprophytic colonization of a bullous/cavitary lesion. The BAL consisted of abundant acute inflammation, crystalline material suggestive of oxalate, and darkly pigmented conidia. Although an extensive search was undertaken, hyphal fragments could not be found. The suspicion of an A. niger infection was confirmed by culture. We believe that even in the absence of hyphal fragments, darkly pigmented, occasionally rough-walled conidia are sufficient evidence to be highly suspicious of an A. niger infection in patients with pulmonary oxalosis.
支气管肺泡灌洗（BAL）材料通常会被送到细胞病理学部门以排除微生物。当标本中出现提示草酸钙的结晶物质时，应查找真菌成分。黑曲霉是与草酸盐晶体存在相关的透明霉菌。曲霉病患者的BAL标本中通常可见菌丝片段，偶尔可见完整的分生孢子梗。我们报告一例患有大疱性/空洞性病变腐生定植的患者。BAL液中含有大量急性炎症细胞、提示草酸盐的结晶物质以及深色色素沉着的分生孢子。尽管进行了广泛查找，但未发现菌丝片段。培养结果证实了黑曲霉感染的怀疑。我们认为，即使没有菌丝片段，对于患有肺部草酸沉着症的患者，深色色素沉着、偶尔壁粗糙的分生孢子也足以高度怀疑黑曲霉感染。
