Invasive cavitary pulmonary aspergillosis in patients with cancer: A clinicopathologic study

Aggressive surgical management in localized pulmonary mycotic and nonmycotic infections for neutropenic patients with acute leukemia: Report of eighteen cases

“…CT scan could help to improve the diagnosis. Like others, we believe the air crescent sign is an insensitive marker for lung cavitation in IPA, 18 appearing long after the onset of the disease. However, another CT sign, the halo sign, appears earlier during the evolution of IPA.…”

“…Cavities occur by separation of the infarcted lung from adjacent viable lung, resulting in an intracavitary sequestrum of necrotic lung tissue. 18 The roentgenologic correlation of this sequence of events is the air crescent sign. 19 Unlike classic aspergilloma, in which the cavity preexists the fungal invasion, in IPA the proposed pathogenesis of cavity formation invokes destruction of lung parenchyma by phagocyte-derived proteolytic enzymes at the periphery of the infarct.…”

Pathologic Manifestations of Invasive Pulmonary Aspergillosis in Cancer Patients: the Many Faces of Aspergillus

“…The necrotic material can then undergo liquefaction and drain into the involved airway, leaving a cavitary deficit. 9 Mediators of infarcted tissue degradation include autolysis, proteolysis from neutrophil enzymes, elastolysis by Aspergillus elastase, and phagocytosis by macrophages and giant cells. 4,9 Nodular infarcts that have cavitated may then be infiltrated with hyphae resulting in mycetoma formation.…”

“…9 Mediators of infarcted tissue degradation include autolysis, proteolysis from neutrophil enzymes, elastolysis by Aspergillus elastase, and phagocytosis by macrophages and giant cells. 4,9 Nodular infarcts that have cavitated may then be infiltrated with hyphae resulting in mycetoma formation. 2 Pulmonary vascular invasion resulting in hemorrhagic infarctions usually produces a large, wedge-shaped lesion that is pleural based with visible thrombosed vessels.…”