Presentation
History of bone marrow transplant.
Patient Data
Multiple pulmonary round infiltrates with surrounding ground-glass opacity suggesting hemorrhage and raising the probability of this representing fungal infection.
Case Discussion
The patient went on to have bronchial washings.
Bronchial washings
Smears consist predominantly of an acute inflammatory exudate admixed with pulmonary macrophages, squamous cells and bronchial cells in a background of granular and cellular debris. Degenerate and reactive cell changes are present throughout. Fungal elements morphologically consistent with Aspergillus present. No evidence of Pneumocystis organisms. No malignant cells are identified.
FINAL DIAGNOSIS: Fungal elements morphologically consistent with Aspergillus present. No evidence of Pneumocystis organisms. No malignant cells are identified.
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