Skip to main content

Advertisement

Log in

Pulmonary aspergillus intracavitary colonization (PAIC)

  • Published:
Mycopathologia Aims and scope Submit manuscript

Abstract

We have attempted to elucidate the natural history of pulmonary aspergillus intracavitary colonization (PAIC) based on more than 350 cases of the disease observed in the last 11 years and on data collected from the literature. The data indicate that PAIC is a dynamic process consequent to the continual growth and death of fungal elements and also with their relationships to the anatomic features of the cavity (valvular mechanisms, vascular alteration). The clinical presentations reflect immunological changes in the host. Metabolites produced by the species of Aspergillus involved affect the clinical presentation of the syndrome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Al-Doory Y. The mycology of the Aspergilli. In: Al-Doory Y, Wagner GE (Eds.). Aspergillosis. Springfield. Charles C. Thomas, Pub. 1985, chap. 2. pp. 7–24.

    Google Scholar 

  2. Alonso P, Leon HP, Cano-Vale F. Transthoracic needle biopsy for diagnosis of lung tumors. Acta Cytol 1971; 15: 209–10.

    Google Scholar 

  3. Anderson CJ, Craig S, Bardana Jr EJ. Allergic bronchopulmonary aspergillosis and bilateral fungus ball terminating in disseminated aspergillosis. J Allergy Clin Immunol 1980; 65: 140–4.

    Google Scholar 

  4. Aslam PA, Eastridge CE, Hughes Jr FA. Aspergillosis of the lung: An eighteen-year experience. Chest 1971; 59: 28–32.

    Google Scholar 

  5. Assem ESK, Turner-Warwick M. Cytophilic antibodies in broncho-pulmonary aspergilloma and cryptogenic pulmonary eosinophilia. Clin Exp Immunol 1976; 26: 67–77.

    Google Scholar 

  6. Audoin MC. L'aspergillose pulmonaires. Formes atypiques. These doctorat. Faculte de Medicine de Paris, 1970.

  7. Avila R. Immunological study of pulmonary aspergilloma. Thorax 1968; 23: 144–52.

    Google Scholar 

  8. Awe RJ, Greenberg SD, Mattox KL. The source of bleeding in pulmonary aspergillomas. Texas Med 1984; 80: 58–61.

    Google Scholar 

  9. Bardana Jr EJ. The clinical spectrum of aspergillosis. Part 2: classification and description of saprophytic, allergic, and invasive variants of human disease. CRC Critical Rev Clin Lab Sci 1980; 13: 85–159.

    Google Scholar 

  10. Bardana Jr EJ. The changing pathogenisis of aspergilloma or ‘fungus ball’. NY State Med 1984; 84: 436–7.

    Google Scholar 

  11. Bardana Jr EJ. Pulmonary aspergillosis. In: Al-Doory Y, Wagner GE (Eds.). Aspergillosis. Springfield, Charles C. Thomas, Pub. 1985; chap. 4, pp. 43–78.

    Google Scholar 

  12. Bayer AS. Diagnosis of aspergillosis. In: Al-Doory Y, Wagner GE (Eds.). Aspergillosis. Springfield, Charles C. Thomas, Pub. 1985; chap. 8, pp. 129–46.

    Google Scholar 

  13. Binder RE, Faling LJ, Pugnatch RD, Mahansaen C, Snider GL. Chronic necrotizing pulmonary aspergillosis: a discrete clinical entity. Medicine 1982; 61: 109–24.

    Google Scholar 

  14. Brandli O. Das aspergillom der lunge. Erged Inn Med Kinderheilk 1984; 53: 1–36.

    Google Scholar 

  15. Breuer R, Baigelman W, Pugatch D. Occult mycetoma. J Comput Assist Tomogr 1982; 6: 166–8.

    Google Scholar 

  16. Campbell MJ, Clayton YM. Bronchopulmonary aspergillosis. A correlation of the clinical and laboratory findings in 272 patients investigated for bronchopulmonary aspergillosis. Am Rev Resp Dis 1964; 89: 186–96.

    Google Scholar 

  17. Carbone PP, Nunnink JC. Aspergillosis infection following radiotherapy. NY State J Med 1984; 84: 434–435.

    Google Scholar 

  18. Castellino RA, Goldstein HM, Stinson EB, Griepp RB. Needle aspiration biopsy technique in pulmonary disease. Application to therapy. JAMA 1970; 213: 463–4.

    Google Scholar 

  19. Costa NP, Andrade EM, Neves A, Motta LMJ, Cabral JRVP, Romao PAA, Carneiro RJ. Micetoma pulmonar intracavitario. Tisio-pneu 1977; 9: 167–86.

    Google Scholar 

  20. Curtis MA, Smith GJW, Ravin CE. Air crescent sign of invasive aspergillosis. Radiology 1979; 133: 17–21.

    Google Scholar 

  21. Dar MA, Ahmad M, Weinstein AJ, Mehta AC, Golish JA. Thoracic aspergillosis (part 1). Overview and aspergilloma. Cleve Clin Q 1984; 51: 615–30.

    Google Scholar 

  22. Davies D (Ed.). British Thoratic and Tuberculosis Association Report. Aspergilloma and residual tuberculosis cavities — the result of a resurvey. Tubercle 1970; 51: 227–45.

    Google Scholar 

  23. Davies D, Sommer AR. Pulmonary aspergillosis treated with corticosteroids. Thorax 1972; 27: 156–62.

    Google Scholar 

  24. Diamond RD, Krezesicki R, Epstein B, Jao W. Damage to hyphal forms of fungi by human leukocytes in vitro. Am J Pathol 1978; 91: 313–23.

    Google Scholar 

  25. Duroux A. Lyse spontanee d'un aspergillome secondaire. J Fr Med Chir Thor 1965; 19: 557–60.

    Google Scholar 

  26. Editorial. Corticosteroids in pulmonary aspergillosis. Brit Med J 1972; 4: 567–8.

  27. Fahey PJ, Utell MJ, Hyde RW. Spontaneous lysis of mycetomas after acute cavitating lung disease. Am Rev Resp Dis 1981; 123: 336–9.

    Google Scholar 

  28. Fromtling RA, Shadomy HJ. An overview of macrophage-fungal interactions. Mycopathologia 1986; 93: 77–93.

    Google Scholar 

  29. Gefter WR, Epstein DM, Miller WT. Allergic bronchopulmonary aspergillosis: less common patterns. Radiology 1981: 140: 307–312.

    Google Scholar 

  30. Gefter WB, Weingrad TR, Epstein DM, Ochs RH, Miller WT. ‘Semi-invasive’ pulmonary aspergillosis. A new look at the spectrum of aspergillus infections of the lung. Radiology 1981; 140: 313–21.

    Google Scholar 

  31. Greene R. The pulmonary aspergillosis: three distinct entities. Or a spectrum of disease. Radiology 1981; 140: 527–530.

    Google Scholar 

  32. Hammerman KJ, Christianson CS, Huntington I, Hurst GA, Zelman M, Tosh FE. Spontaneous lysis of aspergillomata. Chest 1974; 27: 115–21.

    Google Scholar 

  33. Helenon CH, Gallouedec CH, Vannier R, Akoun G, Brocard H. L'arteriographie bronchique dans les aspergillomes. Rev Tuberc Pneumol 1971; 35: 681–94.

    Google Scholar 

  34. Hilvering C, Stevens EAM, Orie NGM. Fever in aspergillus mycetoma. Thorax 1970; 25: 19–24.

    Google Scholar 

  35. Hotchi M. Bronchopulmonary aspergillosis. Jpn J Med Mycol 1987; 28: 192–7.

    Google Scholar 

  36. Israel AL, Ostrow A. Sarcoidosis and aspergilloma. Am J Med 1969; 47: 243–50.

    Google Scholar 

  37. Israel RH, Poe RH, Bomba PA, Gross RA. The rapid development of an aspergilloma secondary to allergic bronchopulmonary aspergillosis. Am J Med Sci 1980; 280: 41–4.

    Google Scholar 

  38. Jeanmart L, Vollont GH, Hennebert A, Jorissen E. Les aspergilloses bronchopulmonaires atypiques. J Belge Radiol 1974; 57: 193–200.

    Google Scholar 

  39. Joynson DHM. Pulmonary aspergilloma. Br J Clin Pract 1977; 31: 207–16.

    Google Scholar 

  40. Katz AS, Weiss W, Steinberg A. The migrating micetoma. Br J Dis Chest 1977; 71: 289–94.

    Google Scholar 

  41. Katzenstein ALA, Liebow AA, Friedman PJ. Bronchocnetric granulomatosis, mucoid impaction, and hypersensitivity reactions to fungi. Am Rev Resp Dis 1975; 11: 497–537.

    Google Scholar 

  42. Krakowka P, Ciszek J, Halweg H. Early stage of aspergilloma of the lung. Pol Med J 1969; 8: 589–93.

    Google Scholar 

  43. Levin E. Pulmonary intracavitary fungus ball. Radiology 1956; 66: 9–15.

    Google Scholar 

  44. Lunetta Q, Bernardini V, Pacenza U, Senis F, Sciotto V, Scalfi F. Les aspergillomes pulmonaires etiologie, evolution, traitment. Poumon Couer 1971; 26: 853–75.

    Google Scholar 

  45. Marais MMR. L'aspergillose pulmonaire etude anatomopathologique de 59 cas inedits. These Doctorat. Universite Paris XIII Faculte de Medicine de Bobgny, Paris XIII, 1975.

    Google Scholar 

  46. Martin-Lalande J, Carraud J, Djebbar A, Jaubertie R. Aspergillose et suppuration episode pyogene suraigu intra-cavitaire apres degenerescence et mort aspergillaire in situ. J Fr Med Clin Thor 1965; 19: 569–89.

    Google Scholar 

  47. McCarthy DG, Pepys J. Pulmonary aspergilloma-clinical immunology. Clin Allergy 1973; 3: 57–70.

    Google Scholar 

  48. Monod O. A propos des aspergillomes. J Fr Med Chir Thorac 1961; 15: 529–32.

    Google Scholar 

  49. Pena CE. Aspergillosis. In: Baker RD (Ed.). The pathologic anatomy of mycoses. Berlin, Springer-Verlag, 1971, pp. 762–831.

    Google Scholar 

  50. Pennington JE. Aspergillus lung disease. Med Clin North Am 1980; 64: 475–90.

    Google Scholar 

  51. Pesle GD, Monod O. Bronchiectasis due to aspergilloma. Dis Chest 1954; 25: 172–83.

    Google Scholar 

  52. Pimentel JC. Novos aspectos morfologicos do ‘aspergilloma pulmonar’. Seus provaveis estadios iniciais e residuais. Gaz Med Port 1959; 12: 195–210.

    Google Scholar 

  53. Pimentel JC. O ‘aspergiloma’ calcificado. Uma nova forma anatomo-clinica do ‘aspergiloma pulmonar’. J Med 1961; 46: 377–84.

    Google Scholar 

  54. Pimentel JC. Pulmonary calcification in the tumor-like form of pulmonary aspergillosis: pulmonary aspergilloma. Am Rev Resp Dis 1966; 94: 208–16.

    Google Scholar 

  55. Przyjemski C, Matti R. The formation of pulmonary mycetomata. Cancer 1980; 46: 1701–4.

    Google Scholar 

  56. Remy J, Arnaud H, Fardou H, Giraud R, Volsin C. Treatment of hemoptysis by embolization of bronchial arteries. Radiology 1977; 122: 33–7.

    Google Scholar 

  57. Renouf JP. L'aspergillome pulmonaire secondaire. A propos d'une observation. These Doctorat. Faculte de Medecine Paris Ouest, 1974.

  58. Rohatgi PK, Rohatgi NB. Clinical spectrum of pulmonary aspergillosis. South Med J 1984; 77: 1291–301.

    Google Scholar 

  59. Rzepecki W. A trial of isolating a tumor-like form of pulmonary cavities infected with aspergilli. I. Preoperative data, diagnostic difficulties. Bronches 1978; 28: 1–11.

    Google Scholar 

  60. Rzepecki W, Harazda M, Dolezal M. A trial of isolating a tumor-like form of pulmonary cavities infected with aspergilli. II. Intra and postoperative, morphologic and serologic data. Bronches 1978; 28: 87–98.

    Google Scholar 

  61. Safirstein BH. Aspergilloma consequent to allergic bronchopulmonary aspergillosis. Am Rev Resp Dis 1973; 108: 940–3.

    Google Scholar 

  62. Sawasaki H. Study on pathogenesis of pulmonary aspergilloma. Jpn J Med Mycol 1981: 22: 6–27.

    Google Scholar 

  63. Sawasaki H. Pulmonary aspergillosis. Tokyo, Igaku-Shoin Ltd, 1984.

    Google Scholar 

  64. Sawasaki H, Horie K, Naito Y, Watabe S, Tajima G, Mizutzni Y. Experimental pulmonary aspergilloma. Mycopathol Mycol Appl 1967: 32: 265–74.

    Google Scholar 

  65. Sawasaki H, Horie K, Tamura S, Uzawa T. On the pathogenesis of pulmonary aspergilloma. Proc Eight Congr ISHAM, Feb 8–12, Massey University, Palmerston North, New Zealand, pp. 125–8.

  66. Schaffner A, Douglas H, Braud A. Selective protection against conidia by mononuclear and against mycelia by polymorphonuclear phagocytes in resistence to aspergillus. Observations on two lines of defense in vivo and in vitro with human and mouse phagocytes. J Clin Invest 1982; 69: 617–31.

    Google Scholar 

  67. Schwartz J. Aspergillosis. In: Sheldon C (Ed.). Pathology decennial. New York, Appleton Century Crofts, 1975, pp. 293–320.

    Google Scholar 

  68. Segretain G, Vieu M. Formes parasitaires des aspergillus dans l'aspergillome bronchique: diagnostic biologique des aspergilloses broncho-pulmonaires. In: Micologie Medicale. Communications et raports presentes aux journees de mycologie medicale, Institut Pasteur et Soc Fr Mycol Med. L'expansion (Ed.). Paris, 1957, pp. 48–54.

    Google Scholar 

  69. Severo LC. Colinizacao intracavitaria pulmonar por Aspergillus niger. Analise de suas peculiaridades. Tese de Doutorado. UFRGS, Porto Alegre, 1987.

    Google Scholar 

  70. Severo LC, Hetzel JL, Palombini BC, Porto NS, Negretto JS, Londero AT. Aspergolloma pulmonar por Aspergillus niger. Apresentacao de caso. J Pneumol 1978; 4: 9–11.

    Google Scholar 

  71. Severo LC, Londero AT, Geyer GR, Picon PD. Oxalosis associated with an Aspergillus niger fungus ball. Report of a case. Mycopathologia 1981; 73: 29–31.

    Google Scholar 

  72. Sheth NK, Varkey B, Wagner DK. Spinal cord aspergillus invasion complication of an aspergilloma. Am J Clin Pathol 1985; 84: 763–9.

    Google Scholar 

  73. Roberts CM, Citron KM, Strickland B. Intrathoracic aspergilloma: role of CT in diagnosis and treatment. Radiology 1987; 165: 123–8.

    Google Scholar 

  74. Slevin ML, Knowles GK, Phillips MJ, Stransfled AG, Lister TA. The air crescent sign of invasive pulmonary aspergillosis in acute leukemia. Thorax 1982; 37: 554–5.

    Google Scholar 

  75. Stevens EAM, Hilvering C, Orie NGM. Inhalation experiments with extracts of Aspergillus fumigatus on patients with allergic aspergillosis and aspergilloma. Thorax 1970; 25: 11–8.

    Google Scholar 

  76. Symmers WStC. Histopathology of aspergillosis of the respiratory system. In: Haller R & Suter, F (Eds.). Aspergillosis and farmer's lung in man and animal. Bern, Hans Huber Pub, 1974, pp. 75–84.

    Google Scholar 

  77. Tenholder MF. The many faces of pulmonary aspergillosis. Primary Care 1985; 12: 353–68.

    Google Scholar 

  78. Turner-Warwick M, Citron KM, Carrol KB, Heard BE, Mitchell DN, Pepys J, Scadding JG, Soutar CA. Immunologic lung disease due to Aspergillus. Chest 1975; 68: 346–55.

    Google Scholar 

  79. Utz JP. The pulmonary mycoses. In: Fishmann, AP (Ed.). Pulmonary diseases and disorders. New York, McGraw-Hill Book Co, 1980, vol 2, chap 108, pp. 1164–81.

    Google Scholar 

  80. Van Adrichem AHM, Gans JC, Van Toorn W. Pulmonale arthus-reactie bij aspergillom. Ned Tijdschr Geneeskad 1971; 115: 462–6.

    Google Scholar 

  81. Villar TG, Pimentel JC, Costa MFE. The tumor-like forms of aspergillosis of the lung (pulmonary aspergilloma). A report of new cases and a review of the portuguese literature. Thorax 1962; 17: 22–38.

    Google Scholar 

  82. Voison C, Biguet J. L'aspergillose dans les lesions pulmonaires residuaelles: problemes diagnostiques, prognostiques et therapeutiques. Bull Int Union Tuberc 1970; 43: 119–20.

    Google Scholar 

  83. Watanabe M, Hotchi M. An autopsy case of ‘fungus ball’ type pulmonary aspergillosis complicated with direct invasion of thoracic aorta and systemic dissemination. Jpn J Med Mycol 1986; 27: 182–9.

    Google Scholar 

  84. Waldhorn RE, Tsou E, Kerwin DM. Invasive pulmonary aspergillosis associated with aspergilloma in sarcoidosis. South Med J 1983; 76: 251–3.

    Google Scholar 

  85. Wright PG, Heard BE. Fungal disease. In: Symmers WStC (Ed.). Systemic pathology. 2nd ed., Edinburg, Churchill Linvingstone, 1976, vol. 1, chap. 7, pp. 346–60.

    Google Scholar 

  86. Yarzabal LA, Pereyra MEP, Josef M. La aspergillosis respiratoria humana en el Uruguay. Thorax 1968; 17: 67–74.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Severo, L.C., Geyer, G.R. & Porto, N.S. Pulmonary aspergillus intracavitary colonization (PAIC). Mycopathologia 112, 93–104 (1990). https://doi.org/10.1007/BF00436504

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00436504

Key words

Navigation