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Invasive aspergillosis Radiology

Angioinvasive aspergillosis Radiology Reference Article

  1. Dr Daniel J Bell ◉ and Assoc Prof Frank Gaillard ◉ ◈ et al. Angioinvasive aspergillosis is the most severe and aggressive form of invasive aspergillosis. It is a life-threatening condition that requires prompt treatment. Fortunately, it is not seen in the general population and only occurs in profoundly immunocompromised patients
  2. g more common, particularly because of the increasing prevalence of immunosuppression and the increasing length of survival of immunosuppressed patients. Cerebral aspergillosis: radiologic and pathologic findings. RadioGraphics 2006; 26: 1239-1242. Link,.
  3. g its own cavity. It is the finding of tissue invasion that allows this entity to be distinguished from the more common aspergilloma 2,5
  4. CONCLUSION: Radiographic findings of invasive aspergillosis of the airways consist of consolidation or ill-defined nodules. At CT, the consolidation can be seen to be peribronchial and the nodules centrilobular
  5. Results: Volumetric high-resolution computed tomography (CT) is the method of choice for lung imaging. Although no CT radiologic pattern is pathognomonic of IFD, the halo sign, in the appropriate clinical setting, is highly suggestive of invasive pulmonary aspergillosis (IPA) and associated with specific stages of the disease
  6. Radiologic manifestations of semi-invasive aspergillosis include unilateral or bilateral segmental areas of consolidation with or without cavitation or adjacent pleural thickening, and multiple nodular areas of increased opacity (, 12 13). The findings progress slowly over months or years (, Figs 9, 10)

Patients with hypersensitivity may develop allergic bronchopulmonary aspergillosis (ABPA), whereas immunocompromised patients can develop semi-invasive or invasive aspergillosis depending on the degree to which their immune system is depressed. Role of pulmonary structure in aspergillosis Invasive pulmonary aspergillosis (IPA) remains difficult to diagnose and to treat. Most common risk factors are prolonged neutropenia, hematopoietic stem cell or solid organ transplantation, inherited or acquired immunodeficiency, administration of steroids or other immunosuppressive agents includin Although no CT radiologic pattern is pathognomonic of IFD, the halo sign, in the appropriate clinical setting, is highly suggestive of invasive pulmonary aspergillosis (IPA) and associated with specific stages of the disease. The ACS is not specific for IFD and occurs in the later stages of infection Aspergillosis is a serious pathologic condition caused by Aspergillusorganisms and is frequently seen in immunocompromised patients. At computed tomography (CT), saprophytic aspergillosis (aspergilloma) is characterized by a mass with soft-tissue attenuation within a lung cavity

Invasive Aspergillosis of the Brain: Radiologic-Pathologic

Invasive aspergillosis: Tissue invasion either angioinvasive or airway invasive, typically occurs in patients with neutropenia or impaired neutrophil function. Imaging Findings. Nodules, single or multiple. Hypodense sign: Central hypodensity, due to infarction. Halo sign: Large bull's eye surrounded by smaller rim ground-glass opacification A series of studies was analysed, and the results suggested that: invasive pulmonary aspergillosis as a series of radiological manifestations different from other types of pulmonary aspergillosis, which may help in its diagnosis and differential diagnosis An aspergilloma can be seen as a mass within a cavity. The mass is typically spherical or ovoid. The air around the aspergilloma takes a crescentic shape, termed the Monod sign, which is distinct from the air crescent sign in recovering invasive aspergillosis. On different positioning of the patient, the mass can be shown to be mobile Invasive aspergillosis in severely immunocompromised patients typically involves the lung [ 11 ], and chest computed tomography (CT) may detect lung involvement at an early stage of infection [ 29, 30 ] Invasive pulmonary aspergillosis (IPA). The differential diagnosis of a child with a cystic or cavitary lung lesion is long and includes congenital and acquired lungs abnormalities. 1 Congenital cystic lesions include lobar emphysema, cystic adenomatoid malformations, pleuropulmonary blastoma, bronchogenic cyst, and pulmonary sequestration

Subacute invasive pulmonary aspergillosis Radiology

  1. Radiological imaging is an essential tool in the management of patients with pulmonary aspergillosis because the main portal of entry of Aspergillus spores is the lung, by way of respiration
  2. Background: Computed tomography (CT) of the chest may be used to identify the halo sign, a macronodule surrounded by a perimeter of ground-glass opacity, which is an early sign of invasive pulmonary aspergillosis (IPA). This study analyzed chest CT findings at presentation from a large series of patients with IPA, to assess the prevalence of these imaging findings and to evaluate the clinical.
  3. Invasive pulmonary aspergillosis may be accompanied by Aspergillus tracheobronchitis in up to 15% of patients. ( 30299367 ) Aspergillus tracheobronchitis is diagnosed on the basis of characteristic-appearing lesions seen in the trachea and large bronchi (findings may include ulceration, nodule, pseudomembrane, or plaque)
  4. Invasive pulmonary aspergillosis: evaluation with MR imaging. Herold CJ(1), Kramer J, Sertl K, Kalhs P, Mallek R, Imhof H, Tscholakoff D. Author information: (1)Department of Radiology, University of Vienna, Austria. Eleven patients with suspected invasive pulmonary aspergillosis underwent magnetic resonance (MR) imaging

Invasive aspergillosis of the airways: radiographic, CT

Airway invasive aspergillosis is less common than angio-invasive aspergillosis and presents clinically as tracheobronchitis, bronchiolitis or bronchopneumonia . Angio-invasive aspergillosis invades the walls of the medium-sized pulmonary arteries with resultant hemorrhage; this form in particular carries significant morbidity and mortality The most significant feature for an early conventional radiologic diagnosis is the nodular pattern--single or multiple--; this allowed a correct diagnosis, at onset, of 20/32 (62%) invasive pulmonary aspergillosis cases. CT provided a further diagnostic contribution by showing a peri-nodular halo Pulmonary aspergillosis represents a common, potentially lethal opportunistic infection that has four unique forms: allergic bronchopulmonary aspergillosis (ABPA), aspergilloma, and invasive and semi-invasive aspergillosis. In individuals who are at risk, pulmonary aspergillosis is characterized by Invasive pulmonary aspergillosis (IPA) is a life-threatening infection in immunocompromised patients. The outcome of such infections depends on early diagnosis and prompt initiation of therapy. The objective of the current study was to determine the significant predictive factors that characterize IPA in patients with cancer

Invasive aspergillosis (IA) caused by the fungus Aspergillus fumigatus is a frequent and life-threatening complication of chemotherapy and bone marrow transplantation with high rates of mortality and morbidity. From: Advances in Applied Microbiology, 201 Pulmonary aspergillosis is a spectrum of mycotic diseases caused by the Aspergillus species, usually A fumigatus. [1, 2] This intensely antigenic and ubiquitous soil fungus is commonly found in the sputum of healthy individuals.However, in susceptible hosts, its ability to invade the arteries and veins facilitates its hematogenous spread. The development of disease and its histologic, clinical. Patho-radiologic correlation of invasive pulmonary aspergillosis in the compromised host Donald P. Orr MD , Departments of Radiology and Pathology, Presbyterian-University Hospital and the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvani

Aspergilloma: gross pathology | Image | Radiopaedia

The spectrum of at-risk populations for invasive Aspergillus infections is expanding, with increased appreciation of diseases such as chronic pulmonary infection and postinfluenza aspergillosis. Fungal superinfections are difficult to distinguish from severe COVID-19 based on clinical or imaging findings, and a high index of suspicion is. Imaging study results in invasive aspergillosis are as follows: Chest radiographic features are variable, with solitary or multiple nodules, cavitary lesions, or alveolar infiltrates that are localized or bilateral and more diffuse as disease progresse

1. Radiology. 1987 Dec;165(3):745-6. Invasive pulmonary aspergillosis: radiologic evidence of tracheal involvement. Vail CM(1), Chiles C. Author information: (1)Department of Radiology, Duke University Medical Center, Durham, NC 27710. Chest radiographs of invasive pulmonary aspergillosis in immunocompromised patients typically show ill-defined pulmonary nodules Invasive aspergillosis is characterised by mycotic vascular invasion, thrombosis, and infarction leading to necrosis and cavitation. The lungs may be seeded via the airways or via the bloodstream. The appearance on x-ray is variable. One-third of cases with symptoms will have a normal chest x-ray For these reasons, imaging findings that suggest the diagnosis of invasive aspergillosis are important. Initially, in the invasive pulmonary aspergillosis, chest radiograph may be normal, but as the infection progresses, single or multiple rounded opacities, pleural-based infiltrates (pulmonary infarctions) and cavitation can develop On imaging, the Monod sign, which refers to the air surrounding the fungal ball, is often confused with the air crescent sign in invasive aspergillosis. In a simple aspergilloma, however, the fungal ball is mobile within the cavity and gravitates to dependent areas, which can be confirmed with prone CT imaging However, there are key imaging features that can alert clinicians to the possible diagnosis of invasive aspergillosis. Invasive Pulmonary Aspergillosis The manifestations of invasive pulmonary aspergillosis (IPA) can be classified according to the underlying pathologic process; however, on many occasions, more than 1 Aspergillus -related.

Guidance on Imaging for Invasive Pulmonary Aspergillosis

Ultrasound Thyroid Aspergillosis 1. Introduction Invasive aspergillosis is a common form of fungal infection in immunocompromised patients. High-risk groups include patients with human immunodeficiency virus infection, leukemia, autoimmune diseases, and organ-transplant patients on pharmacological immunosuppression (1, 2).Pulmonary involvement is the typical presentation of invasive aspergillosis Invasive Aspergillosis (IA) Categories (see footnote for host and radiology criteria): Proven IA: histopathology demonstrating invasive disease or culture of a sterile site PO Probable IA: a susceptible host with suggestive radiology who has either culture, cytopathology/ smear, or serum/BAL galactomannan positive. A (+) serum BD The pulmonary manifestations of aspergillosis can be divided into three categories: (1) semi-invasive (chronic necrotizing) aspergillosis, (2) angioinvasive aspergillosis, and (3) airway invasive aspergillosis (aspergillus bronchopneumonia). Each category has relatively distinct imaging characteristics

Spectrum of Pulmonary Aspergillosis: Histologic, Clinical

Invasive aspergillosis (IA) is a rare complication in solid organ transplant (SOT) recipients. Although IA has significant implications on graft and patient survival, data on diagnosis and management of this infection in SOT recipients are still limited.Discussion. Fungi Journal of Review Advances in the In Vivo Molecular Imaging of Invasive Aspergillosis Matthias Gunzer 1,2,* , Christopher R. Thornton 3 and Nicolas Beziere 4,* 1 Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, 45147 Essen, Germany 2 Leibniz-Institut für Analytische Wissenschaften-ISAS-e.V., 44227 Dortmund, German allergic response to inhaled Aspergillus in asthmatics. Invasive Pulmonary Aspergillosis Acute invasive pulmonary aspergillosis (IPA) is a rapidly progressive infection that occurs in highly immunocompromised patients and carries a mortality upwards of 50 to 80%. [8, 9] The classic risk factor for IPA is neutropenia and the likelihoo DISCUSSION. This case is unique in that it describes the successful chemotherapeutic treatment of locally invasive aspergillosis in a patient with underlying ABPA. The outcome has been poor in previously reported cases of ABPA-related Aspergillus tissue invasion, despite the use of resectional surgery. 2

PURPOSE: To assess the radiographic, computed tomographic (CT), and pathologic findings in invasive aspergillosis of the airways. MATERIALS AND METHODS: The study included nine consecutive patients (aged 17-65 years [median, 49 years]) with pathologically proved invasive aspergillosis of the airways Aspergillus is a mould which may lead to a variety of infectious, allergic diseases depending on the host's immune status or pulmonary structure. Invasive pulmonary aspergillosis occurs primarily in patients with severe immunodeficiency. The significance of this infection has dramatically increased with growing numbers of patients with impaired immune state associated with the management of. To enable non-invasive, longitudinal monitoring of invasive pulmonary aspergillosis in mice, we optimized computed tomography (CT) and magnetic resonance imaging (MRI) techniques for daily follow-up of neutropenic BALB/c mice intranasally infected with A. fumigatus spores Invasive pulmonary aspergillosis (IPA) is a life-threatening lung disease of immuno-compromised humans caused by the ubiquitous environmental mold Aspergillus. Biomarker tests for the disease lack sensitivity and specificity, and culture of the fungus from invasive lung biopsy is slow, insensitive, and undesirable in critically ill patients. A computed tomogram (CT) of the chest offers a. Invasive pulmonary aspergillosis (IPA) is a life-threatening infection of immunocompromised patients with Aspergillus fumigatus, a ubiquitous environmental mould. While there are numerous functioning antifungal therapies, their high cost, substantial side effects and fear of overt resistance development preclude permanent prophylactic medication of risk-patients

FungiScope (https://www.clinicaltrials.gov; National Clinical Trials identifier NCT01731353) is a global registry for emerging invasive fungal infections.FungiScope was approved by the local ethics committee of the University of Cologne, Cologne, Germany (study ID 05-102). The registry includes patients with invasive aspergillosis since 2019 The diagnosis of invasive pulmonary aspergillosis (IPA) is difficult and lacks specificity and sensitivity. In the pathophysiology of Aspergillus fumigatus , iron plays an essential role as a nutrient during infection. A. fumigatus uses a specific and highly efficient iron uptake mechanism based on iron-complexing ferric ion Fe(III) siderophores, which are a requirement for A. fumigatus virulence Most imaging of fungal infection is done with plain chest radiology or CT scanning. An increasing number of imaging investigations use MR, especially for the brain. Sometimes ultrasound is useful especially for cardiac echocardiography (endocarditis) and sometime direct visualization of fungi is possible down a bronchoscope (tracheobronchitis) or endoscope (oesphageal candidiasis or acute.

Pulmonary aspergillosis Radiology Reference Article

Invasive Pulmonary Aspergillosis - PubMe

  1. characterized by localized, slowly progressive, inflammatory destruction of lung tissue and commonly associated with. alcohol use disorder. Invasive aspergillosis: a severe form of. Aspergillus. infection which manifests with severe. pneumonia. and septicemia with potential involvement of other organs (e.g., skin, CNS. ) and mostly occurs in
  2. ation caused by species of Aspergillus, most commonly A. fumigatus, A. flavus, and A. terreus.Aspergillus species are ubiquitous in nature, and inhalation of infectious conidia is a common event.However, tissue invasion is uncommon and occurs most.
  3. Abstract: Invasive pulmonary aspergillosis is a major problem that occurs in severely immunocompromised patients. Airway centered invasive pulmonary aspergillosis is rare in patients with normal immunity or those without critical illness. Computed tomography (CT) is a very useful diagnostic modality, yielding characteristic imaging findings for early diagnosis of this infection in.
  4. In a patient with a medical history of cancer, the most probable diagnosis of an 18FDG-avid pulmonary mass combined with intracranial abnormalities on brain imaging is metastasized cancer. However, sometimes a differential diagnosis with an infectious cause such as aspergillosis can be very challenging as both cancer and infection are sometimes difficult to distinguish

Invasive aspergillosis is a rapidly progressive, often fatal infection that occurs in patients who are severely immunosuppressed, including those who are profoundly neutropenic, those who have received bone marrow or solid organ transplants, and patients with advanced AIDS [] or chronic granulomatous disease. This infectious process is characterized by invasion of blood vessels, resulting in. Diagnostic imaging of experimental invasive pulmonary aspergillosis. Medical Mycology, 2009. Andreas Grol Learning points. Given the significant morbidity and mortality associated with invasive pulmonary aspergillosis (IPA), a presumptive diagnosis can be made based on clinical presentation and radiographic imaging, where antifungal therapy should be initiated even before microbiological and histopathological confirmation The purpose of this study was to compare the high-resolution computed tomography (HRCT) findings of pulmonary invasive aspergillosis and candidiasis in immunocompromised patients. The study included 54 immunocompromised patients (32 men, 22 women; 10 to 68 years of age, median 40 years) with a diagnosis of Aspergillus (n=32) or Candida (n=22) pulmonary infection obtained by sputum culture.

invasive aspergillosis, pneumonia, atelectasis Course / Prognosis / Frequency / Other : Prognosis of invasive aspergillosis in an advanced case is often bad, even with treatment with amphoterecin-B (because of the corresponding immunosupression) The authors present the high-resolution computed tomography findings of an immunosuppressed patient with semi-invasive pulmonary aspergillosis. The main finding consisted of irregular, thick-walled cavity in the right upper lobe and a mass with soft-tissue attenuation within it and thickening of adjacent pleura. Additional findings were bronchial wall thickening associated with a 'tree-in-bud. opportunistic, invasive infection with Aspergillus species mold that usually affects patients with immunocompromise 2,3,4; infection most commonly involves the respiratory tract, presenting as pneumonia, tracheobronchitis, or sinusitis, but may be disseminated Invasive pulmonary aspergillosis in acute leukemia: characteristic findings on CT, the CT halo sign, and the role of CT in early diagnosis. Radiology . 1985 Dec. 157(3):611-4. [Medline] Molecular Imaging of Invasive Pulmonary Aspergillosis Using ImmunoPET/MRI: The Future Looks Bright. Front Microbiol. 2018; 9:691 (ISSN: 1664-302X) Thornton CR. Invasive pulmonary aspergillosis (IPA) is a life-threatening lung disease of immuno-compromised humans caused by the ubiquitous environmental mold Aspergillus

  1. We review the experience at our institution with galactomannan (GM) testing of bronchoalveolar lavage (BAL) fluid in the diagnosis of invasive pulmonary aspergillosis (IPA) among solid-organ transplant recipients. Among 81 patients for whom BAL GM testing was ordered (heart, 24; kidney, 22; liver, 19; lung, 16), there were five cases of proven or probable IPA. All five patients had BAL GM of.
  2. Imaging findings in acute invasive pulmonary aspergillosis: clinical significance of the halo sign. which is an early sign of invasive pulmonary aspergillosis (IPA). This study analyzed chest CT findings at presentation from a large series of patients with IPA, to assess the prevalence of these imaging findings and to evaluate the clinical.
  3. ation caused by species of Aspergillus, most commonly A. fumigatus, A. flavus, and A. terreus.Aspergillus species are ubiquitous in nature, and inhalation of infectious conidia is a frequent event.Tissue invasion is uncommon and occurs most frequently.
  4. ARDS also occurs among invasive aspergillosis patients: a single-center study of 83 ICU patients with probable invasive aspergillosis found that 14% had radiologic signs of ARDS . That ARDS is an important feature of severe COVID-19 and influenza as well as invasive aspergillosis indicates suspicion of aspergillosis is warranted when COVID-19.
  5. The symptoms of aspergillosis vary depending upon the specific form of the disorder present. The lungs are usually affected. Aspergillosis can present as an allergic reaction, an isolated finding affecting a specific area of the body (e.g., the lungs, sinuses or ear canals), or as an invasive infection that spreads to affect various tissues, mucous membranes or organs of the body
  6. g molds found in our environment. As Aspergillus species are opportunistic, they cause disease primarily in patients who are immunocompromised. The organs that are most commonly involved are the lungs and sinuses. Invasive aspergillosis can spread hematogenously and may involve the.

Aspergillosis, Angioinvasive Radiology Ke

Probable invasive aspergillosis without prespecified radiologic findings: proposal for inclusion of a new category of aspergillosis and implications for studying novel therapies. Clin Infect Dis 2010 ;51: 1273 - 1280 The combination of host factors predisposing to invasive aspergillosis (e.g., prolonged neutropenia), compatible clinical and radiologic findings (e.g., pulmonary nodule), and two consecutive positive serum galactomannan assays can be equated with probable invasive aspergillosis and obviate the need for an invasive procedure Aspergilloma/Mycetoma fungus ball preexisting cavity, bulla, bronchiectasis saprophytic sarcoidosis, CF Hemoptysis round opacity within cyst or cavity air crescent mobile pleural thickening Semiinvasive Aspergillosis Mildly immunosuppressed hosts focal consolidation > cavity > air crescent > thick-walled cyst > fungus ball Invasive Aspergillosis Immunocompromised hosts granulocytopenia single. The clinical presentation of Aspergillus lung disease is determined by the interaction between fungus and host. Invasive aspergillosis develops in severely immunocompromised patients, including those with neutropenia, and increasingly in the non-neutropenic host, including lung transplant recipients, the critically ill patients and patients on steroids

CT findings and differential diagnosis in adults with

Radiological signs in chest medicine

Aspergilloma Radiology Reference Article Radiopaedia

The purpose of this study was to establish the diagnostic value of central hypointensity (hypodense sign) in lung consolidations or nodules, in severely immunocompromised or neutropenic patients, suspected of having invasive pulmonary aspergillosis (IPA), and to assess its recognition on unenhanced CT scans Data were collected from patients admitted to the ICU between Jan 1, 2009, and June 30, 2016. Invasive pulmonary aspergillosis was diagnosed in 83 (19%) of 432 patients admitted with influenza (influenza cohort), a median of 3 days after admission to the ICU. The incidence was similar for influenza A and B A recent pilot clinical study demonstrated the applicability of MDVI to human pulmonary fungal infections. MDVI also improves objectivity of radiological assessment of therapeutic response to antifungal therapy and merits more extensive evaluation in patients with invasive aspergillosis, as well as other fungal and bacterial pneumonias Rare hypersensitivity lung disease may be caused by Aspergillus species. Can be seen with ABPA or separate from it as response to infection with Mycobacterium, other fungi, or Echinococcus. Distal airway lumen replacement by necrotizing granulomas. Imaging similar to ABPA, may predominantly affect more distal airway

Initial CT manifestations of invasive pulmonary

Invasive pulmonary aspergillosis is a major cause of morbidity and mortality in neutropenic patients. Microbiological and serological tests are of limited value. The diagnosis should be considered in neutropenic patients with fever not responding to antibiotics, and typical findings on thoracic computed tomography scan. Whenever possible, diagnosis should be confirmed by tissue examination The prognosis of invasive aspergillosis is significantly worse than the prognosis of other forms of sinus aspergillosis and mortality rate remains high, especially in the setting of cerebral involvement. A recent study reported a mortality rate of 40% associated with invasive orbital aspergillosis and 50% with CNS involvement Bronchial washings. Smears consist predominantly of an acute inflammatory exudate admixed with pulmonary macrophages, squamous cells and bronchial cells in a background of granular and cellular debris. Degenerate and reactive cell changes are present throughout. Fungal elements morphologically consistent with Aspergillus present Invasive aspergillosis with multiple cardiac manifestations is rare but usually fatal, and the diagnosis is challenging. A combination of clinical and imaging findings, isolation of Aspergillus, serological evidence, and histopathologic demonstration of invasion are necessary. 1 This case demonstrates the use of CMR to accurately document.

Managing Infections in Patients With Hematologic Malignancies

Imaging Findings in Acute Invasive Pulmonary Aspergillosis

Article - Invasive Pulmonary Aspergillosis - Applied Radiolog

Invasive aspergillosis (IA) is a rare complication in solid organ transplant (SOT) recipients. Although IA has significant implications on graft and patient survival, data on diagnosis and management of this infection in SOT recipients are still limited. Discussion of current practices and limitations in the diagnosis, prophylaxis, and treatment of IA and proposal of means of assessing. It is more common than the invasive form; Usually occurs in a cavity from TB or sarcoid; The ball is composed of hyphae, mucous and cellular debris; Hemoptysis is a common symptom; Imaging Findings. In secondary, non-invasive (saprophytic) aspergillosis. The fungus ball is usually freely movable and will move to the dependent surface on. Imaging study showed right upper lung mass, and mass resection showed aspergilloma without tissue invasion on histology. The patient developed visual impairment a few weeks later, and MRI of the brain revealed bilateral sphenoid sinusitis and pituitary invasion. The trans-sphenoidal biopsy confirmed invasive Aspergillus infection Radiologic abnormalities can vary, reflecting different pathologies. Prospective studies reporting poor outcomes in CAPA patients underscore the urgent need for strategies to improve diagnosis, prevention, and therapy. Invasive aspergillosis is frequently recognized in persons who have severe immunosuppression, especially that associated with. Aspergillus infection was mostly reported with high mortality rates and a bad prognosis in immunocompromised patients, but data were lacking on the clinical characteristics of aspergillus infection in liver cirrhosis. The aim of this study was to retrospectively assess the morbidity and mortality rate, clinical manifestation, risk factors, and medication of invasive pulmonary aspergillosis.

Allergic aspergillosis of the respiratory tract | EuropeanChronic pulmonary aspergillosis: rationale and clinical

Bronchoalveolar lavage with smear, culture and antigen detection has excellent specificity and reasonably good positive predictive value for invasive aspergillosis in immunocompromised patients. Radiology may give a clue to the diagnosis but not sufficiently specific to be diagnostic Invasive pulmonary aspergillosis (IPA) is the leading invasive fungal disease in high-risk hematologic patients, including those with acute myeloid leukemia (AML) receiving chemotherapy for induction of remission, and allogeneic hematopoietic cell transplant (HCT) recipients.1,2 Studies conducted in the 1990s and early 2000s reported crude mortality rates of 60-80%.3 However, recent data. Invasive sphenoid sinus aspergillosis is a rare but life-threatening condition usually found in immunocompromised patients. When involving cavernous sinus and surrounding structures, patients are frequently misdiagnosed with a neoplasm or sellar abscess. Timely diagnosis and intervention are crucial to patients' outcomes. The objective of this study is to review cases of invasive sphenoid. Invasive pulmonary aspergillosis, discrete nodule. (a) The nodule comprises coagulation necrosis of the lung tissue ( ) and acute hemorrhage usually accompanies the necrosis ( ) and may mimic a halo sign on CT (Hematoxylin-Eosin, X20). (b) Zone formation (mimicking an annual ring) of hyphae aligned in a radial pattern