Colonizing Fungi in Cavitary Lesions of Lung – A Clinicopathological Study

Objective: Patients with preexisting lung cavities are prone to develop fungal masses inside the cavity. Though Aspergillus sp. is the most common fungus colonizing these cavities other fungi may rarely show colonization. Material and Method: Retrospective study carried out in a tertiary care hospital from 1993 to 2008. All patients diagnosed with a fungal ball on chest radiographs/CT chest with subsequent histological confirmation were analysed. Demographic data, clinical, radiological and surgical findings were retrieved from the medical records. Histopathology slides were reviewed along with special stains for fungi. Fungi were identified on morphology and/or culture. Results: There were 25 patients in the study period with 20 males and 5 females. A past history of tuberculosis was present in 17 patients. The colonizing fungi were identified as Aspergillus sp. in 20, dematiaceous fungi in 3 and mixed infection (Aspergillus sp. and Candida sp.) in 2. Culture confirmation was available in five specimens, which showed Aspergillus fumigatus in 2, Aspergillus flavus 1, Pseudallescheria boydii 1 and Candida albicans (in mixed infection) in 1. Conclusion: Fungi other than Aspergillus sp. can colonize pulmonary cavities. Hence an attempt at identification of the colonizing fungus either with morphological or cultural evidence should be done. (Tur Toraks Der 2011; 12: 19-26)