Expanding the Spectrum of Chronic Necrotizing (Semi-Invasive) Aspergillosis: A Series of 8 Cases Presenting as Radiologically Solid Lung Nodules Mimicking Malignancy (Kamtai Dermawan et al., 2019)
This paper provides a good illustration of the difficulties with diagnosis via x-ray or CT scan – 6% of fungal biopsies/resections resembled cancer on imaging and could not be classified as a well-recognized form of aspergillosis. It also illustrates the difficulty classifying these nodules and lesions into a specific form of aspergillosis and it is necessary to use a range of names i.e. chronic pulmonary, chronic necrotising, semi-invasive etc.
The Clinical Characteristics and Prognosis of ABPA Are Closely Related to the Mucus Plugs in Central Bronchiectasis (Lu et al., 2019)
The characteristics of Allergic Bronchopulmonary Aspergillosis (ABPA) based on its radiological classification is still unclear. This study investigates the clinical significances of ABPA patients with central bronchiectasis (ABPA-CB) by different radiological classifications of mucus plugs. It concludes that the clinical characteristics and prognosis of ABPA-CB patients are closely related to its radiological phenotype of mucus plugs in the central bronchiectasis. The authors recommend that clinicians should promote a diversity of personalised treatments for different patients with different radiological characteristics.
Efficiency of A. fumigatus-Specific IgG and Galactomannan Testing in the Diagnosis of Simple Aspergilloma (Sehgal et al., 2019)
In low and middle-income countries, imaging facilities required for diagnosis of CPA are not always available. This study investigates the role of Aspergillus fumigatus-specific IgG in serum, and galactomannan (GM) in bronchoalveolar lavage fluid (BALF) and serum for the diagnosis of simple aspergilloma as a precursor of CPA. The authors determine the cut‐off value of A. fumigatus‐specific IgG in serum, and GM in BALF and serum, in the diagnosis of SA. Results suggest that A fumigatus‐specific IgG at a cut‐off value of 27 mgA/L has a reasonable diagnostic performance in the workup of SA. The use of serum GM followed by BALF‐GM in addition to A fumigatus‐specific IgG further improves the diagnostic performance.
Prospective Study of the Serum Aspergillus-specific IgG, IgA and IgM Assays for Chronic Pulmonary Aspergillosis Diagnosis (Ma et al., 2019)
This study from China aimed to investigate the diagnostic values of serum Aspergillus-specific IgG, IgA and IgM antibodies in patients with CPA. The sensitivity and specificity of serum Aspergillus-specific IgG assay are satisfactory for diagnosing CPA, while the performance of Aspergillus-specific IgA assay is moderate. Aspergillus-specific IgM assay and serum GM test have limited value for CPA diagnosis.