COPD合并侵袭性肺曲菌病的诊断和治疗摘要.ppt

* * Photograph of an autopsy specimen from the left upper lobe shows an irregular cavitary lesion with regular margins and a dark brown appearance caused by necrotic material and superimposed Aspergillus infection. * High-power photomicrograph shows massive A niger with its characteristic black appearance. * (a) Chest CT scan (mediastinal window) obtained at the level of the carina shows a thickened, narrowed right main bronchus with associated right upper lobe collapse. * (b) Bronchoscopic image shows elevated, whitish mucosal lesions in the right main bronchus (arrow). * (c) High-power photomicrograph (original magnification, x400; hematoxylin-eosin stain) of a biopsy specimen from the right upper lobe reveals massive Aspergillus hyphae invading the bronchial epithelium (arrows). * Invasive bronchiolar aspergillosis in a patient who had undergone bone marrow transplantation. (a) Thin-section CT scan (lung window) shows peripheral branching structures associated with focal areas of consolidation in the right lower lobe. (b) Photograph of the corresponding autopsy specimen shows multiple yellowish acinar nodules. * (c) High-power photomicrograph of a lung biopsy specimen demonstrates complete destruction of the bronchiolar wall by Aspergillus infection. * Bronchopneumonia aspergillosis, (a) Conventional CT scan through the upper lungs shows a segmental area of consolidation in the right upper lobe with visible air bronchogram. * (b) Photograph of the corresponding autopsy specimen shows segmental consolidation. * (c) High-power photomicrograph of a small area of consolidation shows tissue necrosis. Scattered Aspergillus organisms can be identified in the necrotic tissue (arrows). * Obstructing bronchopulmonary aspergillosis in a 29-year-old man with AIDS. CT scan shows multiple rounded and tubular areas of increased attenuation in both lower lobes, findings that are consistent with mucus-filled air