A patient can develop a single lesion or multiple lesions of varying sizes
Although aspergilloma can be asymptomatic, many patients present with a combination of signs and symptoms that include:
* Blood-tinged sputum
* Weight loss
* Chest pain
* Indeterminate nodule.
Other forms of pulmonary aspergillosis include acute inhalational Aspergillus pneumonia, invasive pulmonary aspergillosis, and allergic bronchopulmonary aspergillosis.
The clinical diagnosis of pulmonary aspergilloma is made by the combination of a hemoptysis presentation and a radiographic demonstration of an intracavitary mass. A chest radiograph or a CT scan will reveal an upper lobe or apical opaque round mass, surrounded by a cavity resembling an "air crescent" or a "meniscus" sign, with adjacent pleural thickening
Laboratory studies using double immunodiffusion tests will show a high number of precipitins, which are present in 92% to 100% of patients with aspergilloma; and enzyme-linked immunosorbent assay will show high immunoglobulin G antibody titers.
Pathologically, microscopic examination reveals uniform hyphae ranging from 3 to 6 µm in width, regularly septate, with parallel contours and acute-angle branching from the parent hyphae. The branching is progressive and dichotomous. Viable hyphae are basophilic and are therefore best visualized with Grocott-Gomori methenamine–silver nitrate stain . In contrast, necrotic hyphae are hyaline or eosinophilic.9,10 Conidiophores originate from the basal (also known as foot) cell located
on the supporting hyphae and terminate in a vesicle at the apex