ASPERGILLUS IN CYTOLOGY SPECIMENS - A REVIEW OF 45 SPECIMENS FROM 36 PATIENTS

Objective. To assess the clinical significance associated with the ide ntification of fungal elements consistent with Aspergillus in cytology specimens. Materials and Methods. For all cytology specimens with rep orted fungal elements consistent with Aspergillus, reported over a 9 y r and 8 mo period at The Cleveland Clinic Foundation, the patient's me dical charts were reviewed with particular attention to underlying dis ease, presentation treatment, and clinical course. Cytology results we re compared with available microbiologic cultures and tissue specimens in all of the patients. Results. Forty-five cytology specimens with A spergillus fungal from 36 patients, were identified Twenty-six patient s had concurrent specimens sent for culture in whom 11 grew Aspergillu s species (10 Aspergillus fumigatus), eight grew organisms other than Aspergillus, and seven were no growth. A total of 16 patients (44%) we re treated with antifungal treatment (Amphotericin B). Treatment with Amphotericin B was significantly associated with a concurrent growth o f Aspergillus species (9/11 patients with Aspergillus culture positive vs. 7/25 patients without a positive culture for Aspergillus, P value = 0.004 (ODDS ratio = 11, 95% confidence interval: #1.6 - 104, 2-tail ed Fisher exact test.) Conclusions. The presence of fungal forms consi stent with Aspergillus in cytology specimens is neither specific nor s ensitive for significant infection due to Aspergillus. Treatment with Amphotericin B is more likely To be instituted when a concurrent clini cal specimen grows Aspergillus species in culture. (C) 1997 Wiley-Liss , Inc.