A case of suspected allergic bronchopulmonary aspergillosis by bronchoscopic exfoliative cytodiagnosis

We report herein on a case of allergic bronchoalveolar aspergillosis (ABPA) with hyphae and Charcot-Leyden crystals against a necrotic background stained with Papanicolaou stain. Lung carcinoma was initially suspected before bronchoscopic brush cytology. Lung carcinoma or tuberculosis is sometimes suspected first in cases of aspergillosis. The pathological diagnosis is important because the seroprevalence and culture-positive rate are very low, and degenerated or vacuolated Aspergillus hyphae do not stain well with Papanicolaou stain. Careful observation of cytological specimens in a necrotic background is therefore required, considering the possibility of aspergillosis.