PMC5369366_01
(A) An axial image from a chest CT shows bilateral upper lobe lung nodules and consolidative opacities. (B) Airway inspection revealed an endobronchial mass in the lingula. (C) The mass contained abundant septate fungal hyphae branching at acute angles within necrotic lung tissue. Photomicrograph is shown at x63 magnification, Gomori methenamine silver stain.
gr1.jpg
PMC5369366_01_gr1.jpg
fig1
Computed tomography scan of the lung showed multifocal upper lobe centrilobular nodules, patchy consolidations with air bronchograms, and small areas of cavitation (Fig. 1A), findings that were not present prior to ibrutinib initiation. Bronchoscopy revealed endobronchial masses in the lingula and right upper lobe (Fig. 1B). Biopsy of the masses showed necrotic mucosa containing septate fungal hyphae with acute angle branching, consistent with Aspergillus (Fig. 1C).