Diagnostic criteria for different management of chronic pulmonary aspergillosis (CPA)
| Term | Definition |
| Simple aspergilloma | Single pulmonary cavity containing a fungal ball, with serological or microbiological evidence implicating Aspergillus spp. in a non-immunocompromised patient with minor or no symptoms and no radiological progression over at least 3 months of observation. |
| CCPA | One or more pulmonary cavities (with either a thin or thick wall) possibly containing one or more aspergillomas or irregular intraluminal material, with serological or microbiological evidence implicating Aspergillus spp. with significant pulmonary and/or systemic symptoms and overt radiological progression (new cavities, increasing pericavitary infiltrates or increasing fibrosis) over at least 3 months of observation. |
| CFPA | Severe fibrotic destruction of at least two lobes of lung complicating CCPA leading to a major loss of lung function. Severe fibrotic destruction of one lobe with a cavity is simply referred to as CCPA affecting that lobe. Usually the fibrosis is manifest as consolidation, but large cavities with surrounding fibrosis may be seen. |
| Aspergillus nodule | One or more nodules which may or may not cavitate are an unusual form of CPA. They may mimic tuberculoma, carcinoma of the lung, coccidioidomycosis and other diagnoses and can only be definitively diagnosed on histology. Tissue invasion is not demonstrated, although necrosis is frequent. |
| SAIA | Invasive aspergillosis, usually in mildly immunocompromised patients, occurring over 1–3 months, with variable radiological features including cavitation, nodules, progressive consolidation with “abscess formation”. Biopsy shows hyphae in invading lung tissue and microbiological investigations reflect those in invasive aspergillosis, notably positive Aspergillus galactomannan antigen in blood (or respiratory fluids). |
CCPA: chronic cavitary pulmonary aspergillosis; CFPA: chronic fibrosing pulmonary aspergillosis; SAIA: subacute invasive aspergillosis/chronic necrotising/semi-invasive.