Pap stain, medium power:
Hyphae with pale staining, acute angle branching
Image courtesy: Michael Riben MD
Pap stain, very high power:
Hyphae with acute angle branching and negatively staining septae
Image courtesy: Michael Riben MD
GMS stain, medium power:
Note thin hyphae with acute angle branching and septations
GMS stain, low power:
Branching fungal hyphae. NOTE the oxalate crystal on upper right
GMS stain, high power:
Note acute angle branching and septations
Iron stain, high power:
Red staining fungal ball - made of numerous acute branching hyphae.
Blue staining hemosiderin laden macrophages in background
Image courtesy: Michael Riben MD
Features
• Bronchioloalveolar lavage or washing
• Soft tissue masses
• Sinonasal washings
• Aspergillus spp.
• Predominant form: Hyphae, occasionally conidia
• Location: Extracellular
• Features:
– Branching of hyphae at 45° (acute)
– Septations present
• Rare background oxalate crystals
• Branching septate hyphae present, correlation with cultures recommended