Unusual aspects of allergic bronchopulmonary fungal disease: Report of two cases due to Curularia organisms associated with allergic fungal sinusitis Academic Article Article uri icon

Overview

MeSH Major

  • Adenocarcinoma
  • Algorithms
  • Biomarkers, Tumor
  • Carcinoma, Squamous Cell
  • Immunohistochemistry
  • Lung Neoplasms

abstract

  • We report two cases of allergic bronchopulmonary fungal disease (ABPFD) caused by Curvularia sp and associated with allergic fungal sinusitis (AFS). Curvularia lunata was cultured in one case and Curvularia senegalensis was cultured in the other. Based on these cases and a review of the literature, we discuss unusual clinical and pathologic features that can occur in ABPFD. Unusual clinical aspects of ABPFD include associated AFS, absence of asthma, progression to Churg-Strauss angiitis and granulomatosis, concomitant hypersensitivity pneumonitis, and underlying cystic fibrosis. Atypical pathologic features that may occur in ABPFD include follicular bronchiolitis, xanthomatous bronchiolitis, limited tissue invasion, fungus balls, and association with unusual fungi. Prominent follicular bronchiolitis and xanthomatous bronchiolitis were misleading histologic features in one of our cases and led to a delay in recognition of the diagnosis. Both patients presented primarily with AFS; ABPFD was detected subsequently. This suggests that a small subset of patients with AFS may be at risk for ABPFD. The goal of this review is to increase awareness of unusual clinical and pathologic manifestations of ABPFD. It is hoped that this will result in accurate diagnosis and proper therapy, especially for patients who present with atypical features. Unusual fungal species should be considered in patients who have clinical findings compatible with ABPFD but who do not demonstrate immunologic reactivity to Aspergillus sp, especially Aspergillus fumigatus. In addition, ABPFD should be considered in patients with AFS who develop new pulmonary lesions.

publication date

  • January 1991

Research

keywords

  • Academic Article

Identity

Digital Object Identifier (DOI)

  • 10.1016/0046-8177(91)90106-Y

PubMed ID

  • 1748430

Additional Document Info

start page

  • 1240

end page

  • 8

volume

  • 22

number

  • 12