Bronchial washing cytology: There are numerous acute inflammatory cells (abscess) and a few acute angle branching fungal hypae are seen. Diagnosis of cytology: 1. Negative for malignancy. 2. Aspergilloma.
Gross findings: Pleural surface is irregular and slightly thickened. On CT guided sections, there are a dilated bronchi which filled with green muddy materials. The remaning parenchyma shows multiple curd-like caseous necrosis of variable sizes.
Microscopic findings: The dilated bronchi contains acute angle branching fungal material. The histochemical stain for fungi (GMS) shows definite acute angle branching and hypae, so consistent with aspergillus spp. The last photo shows chronic granulomatous inflammation with caseous necrosis, consistent with tuberculosis. The result of TB-PCR is positive for AFB.
Final pathological diagnosis: 1. Bronchiectasis
2. Aspergilloma
3. Chronic granulamatous inflammation, consistent with tuberculosis.
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