Diagnosis of Chronic Pulmonary Aspergillosis: Clinical, Radiological or Laboratory?

Abstract

Chronic pulmonary aspergillosis (CPA) is a chronic progressive lung disease associated with a poor prognosis and a 5-year mortality rate of approximately 40–50%. The disease is characterized by slowly progressive destruction of the lung parenchyma, in the form of multiple cavities, nodules, infiltrates or fibrosis. CPA can be challenging to diagnose due to its non-specific symptoms and similarities with other respiratory conditions combined with the poor awareness of the medical community about the disease. This can result in delayed treatment even for years and worsening of the patient’s condition. Serological tests certainly play a significant role in diagnosing CPA but cannot be interpreted without radiological confirmation of CPA. Although many data are published on this hot topic, there is yet no single definitive test for diagnosing CPA, and a multidisciplinary approach which involves a combination of clinical picture, radiological findings, microbiological results and exclusion of other mimicking diseases, is essential for the accurate diagnosis of CPA.

Chronic pulmonary aspergillosis: comprehensive insights into epidemiology, treatment, and unresolved challenges

“…(serological or microbiological testing). 54 , 148 , 149 Guidelines emphasize the importance of combining chest CT with specific Aspergillus IgG antibody measurements in the diagnostic process. 150 , 151 AN lacks distinct imaging features and its diagnosis often requires biopsy or surgical resection to directly demonstrate Aspergillus infection within the lesion.…”