Invasive aspergillosis presenting as hilar masses with stenosis of bronchus: A case report

Figure 1 Contrast-enhanced chest computed tomography images (2018-04-07). A-C: Mediastinal window; D: Lung window. Contrast-enhanced chest computed tomography scan revealed enlarged mediastinum and hilum lymph nodes (yellow arrow) and an enlarged left hilum with a mass-like lesion leading to stenosis of the proximal part of the left upper bronchus (white arrow).

Figure 2 Bronchoscopy manifestations. A: Bronchoscopy (2018-04-16) showed redness as well as thickening of bronchial membrane and bronchial stenosis in the left main bronchus; B: Repeated bronchoscopy (2019-03-26) showed thickening of left main bronchus, which was better compared to the former done on 2018-04-16.

Figure 3 Histological and microbiological evidence of fungal infection. A: Fungal elements showing the 45° branching hyphae within biopsies under bronchoscopy (hematoxylin–eosin stain, 400×); B: Periodic Acid-Schiff staining was positive (400×); C: Grocott staining was positive (400×); D: Fungal fluorescence staining of bronchial membrane brushing sample done on 2019-3-26 revealed branching septate hyphae.

Figure 4 Repeated chest computed tomography scan images (2019-03-24). A-C: Mediastinal window; D: Lung window. Repeated chest computed tomography scan revealed improvement and diminishment of the mass-like lesion and mediastinum and hilum lymph nodes compared to the computed tomography scan done on 2018-4-7.