PulmonaryHyalinizing GranulomaAssociated withAspergillus Infection

A38-year-old immunocompetent manwithoccupational exposure toAspergillus presented withdyspnea, pleuritic chest pain, andhemoptysis. Chestroentgenograms andcomputed tomography scans demonstrated multiple pulmonary nodules bilaterally. Aninitial setofbronchial washing cultures grewAspergillus fumigatus, serologic testing showedanelevated anti-Aspergillus titer, andimmunodiffusion testing was positive forantibody against A.fumigatus andA.niger. Therewasnomicrobiologic or serologic evidence ofinfection byother pathogens, andnoclinical orlaboratory evidenceofautoimmune disease. An openlungbiopsy wasdiagnostic ofpulmonary hyalinizing granuloma. Thisnovel association withAspergillus infection notonlyexpandsthespectrum ofpathogens linked topulmonary hyalinizing granuloma but alsodocuments anewpattern oflungdisease thatcanbecaused byAspergillus. IntJSurgPathol 11(1):39-42, 2003