Fruiting bodies of Aspergillus: An unusual finding in histopathology
A 62-year-old female patient who was an agriculturist presented to us in a critically ill-condition and had complaints of cough and hemoptysis since 3 months and also had respiratory distress at presentation. A chest X-ray was performed, which showed a left sided hilar mass. A computed tomography scan of the thorax revealed a moderately enhancing soft-tissue density lesion measuring 6 cm × 4.9 cm × 4 cm. in the left hilar region extending to apicoposterior segment of left upper lobe. A bronchoscopy was performed, which revealed a mass lesion in the left main bronchus. With a clinical and radiological diagnosis of lung carcinoma, a biopsy was carried out.\nThe specimen obtained for histopathological examination consisted of greywhite, friable soft-tissue aggregate measuring 0.5 cm × 0.5 cm. Examination of Hand E stained sections revealed mainly necrotic tissue and clusters of tumor cells with crush artefact []. Amidst the necrotic material were seen branching septate hyphae of Aspergillus. Apart from hyphal forms, many fruiting bodies of Aspergillus were also seen []. A methenamine silver stain was carried out, which highlighted the fungi []. On immunohistochemistry, the tumor cells were positive for cytokeratin and synaptophysin. A diagnosis of small cell carcinoma of lung with co-existent Aspergillosis was made. Our patient was then lost to follow-up and hence culture and species identification could not be carried out.