Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug;13(8):2004-2011.e1.
doi: 10.1016/j.jaip.2025.04.025. Epub 2025 Apr 24.

Roles of Mycological and Pathological Examinations of Bronchoscopic Specimens in the Diagnosis of Allergic Bronchopulmonary Aspergillosis/Mycosis

Katsuyoshi Tomomatsu  1 , Jun Tanaka  1 , Tsuyoshi Oguma  1 , Takashi Ishiguro  2 , Hirokazu Taniguchi  3 , Yoshikazu Yamaji  4 , Naoki Koshimizu  5 , Hidekazu Matsushima  6 , Teruaki Nishiuma  7 , Junko Suzuki  8 , Yutaka Ito  9 , Takae Tanosaki  10 , Takashi Abe  11 , Mikio Toyoshima  12 , Naoki Okada  1 , Shigeaki Hattori  1 , Koichiro Asano  13 ; Allergic Bronchopulmonary Aspergillosis/Mycosis Research Program
Collaborators, Affiliations
Free article

Roles of Mycological and Pathological Examinations of Bronchoscopic Specimens in the Diagnosis of Allergic Bronchopulmonary Aspergillosis/Mycosis

Katsuyoshi Tomomatsu et al. J Allergy Clin Immunol Pract. 2025 Aug.
Free article

Abstract

Background: Colonization by filamentous fungi in the bronchi is an essential pathogenic component of allergic bronchopulmonary aspergillosis/mycosis (ABPA/ABPM). Mycological or pathological examination of mucus plugs and bronchial lavage fluid directly recovered from the lower airways using bronchoscopy may improve the diagnosis of ABPA/ABPM.

Objective: This study investigated the usefulness of mycological and pathological examinations of bronchoscopic specimens in the diagnosis of ABPA/ABPM.

Methods: We retrospectively analyzed cases of ABPA/ABPM identified in a Japanese nationwide survey conducted in 2020. The diagnosis of ABPA/ABPM was made based on the criteria of Asano et al. RESULTS: Bronchoscopy was performed in 307 of 423 patients with ABPA/ABPM (73%). Among the cases in which sputum and mucus plugs or bronchial lavage fluid were examined microbiologically (n = 216), the positive culture rate for fungi was significantly higher in the mucus plugs and bronchial lavage fluid than in the sputum (46% vs 35%; P = .001). Aspergillus spp, followed by Schizophyllum commune and Penicillium spp, were the most common fungi identified in mucus plugs and bronchial lavage fluid or in sputum. Pathological examination of mucus plugs was performed in 227 cases, and fungal hyphae were identified in approximately half of the cases (n = 113). After bronchoscopic examination, the diagnostic score of the criteria of Asano et al increased from 6.4 ± 1.2 to 7.0 ± 1.3 (P < .001), resulting in a higher rate of definite ABPA/ABPM diagnosis fulfilling six or more components of those criteria (77% vs 87%; P < .001).

Conclusion: Diagnostic bronchoscopy with detailed mycological and pathological evaluations can contribute to a more accurate diagnosis in some cases of ABPA/ABPM.

Keywords: Allergic bronchopulmonary aspergillosis; Allergic bronchopulmonary mycosis; Bronchoscopy; Diagnosis; Fungi.

PubMed Disclaimer

LinkOut - more resources