Figure 1.(A) AP Supine radiograph. (B-D) CT Pulmonary Window, axial, sagittal, and coronal reconstructions, respectively. Multiple thick-walled cavities of varying sizes, and areas containing a Tree-in-Bud pattern are present in both Upper and Lower Lobes. An intracavitary aspergilloma is seen in the anterior segment of the LUL (Circles). A large mucoid impaction (Arrow) with distal air-trapping (Asterisk) is present in the Lingula. Mucoid impactions are present in both Lower Lobes.
Figure 2. Due to the patient’s neurologic symptoms an MRI scan was performed. The heterogeneous lesion in the right Frontal lobe (Circle) was biopsied.
Figure 3. Brain biopsy specimen. (A) H&E stain, 100X. Septated hyphae at 45°angles (Circle) on necrotic background, compatible with Aspergillosis are present (B) Gomori Stain 100X. Septated, Gomori positive hyphae are seen. (C) PAS Stain 100X. Septated PAS positive hyphae are present.