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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medecol</journal-id><journal-title-group><journal-title xml:lang="ru">Медицина и экология</journal-title><trans-title-group xml:lang="en"><trans-title>Medicine and ecology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2305-6045</issn><issn pub-type="epub">2305-6053</issn><publisher><publisher-name>Карагандинский медицинский университет</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.59598/ME-2305-6053-2025-115-2-163-170</article-id><article-id custom-type="elpub" pub-id-type="custom">medecol-1008</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>НАБЛЮДЕНИЯ ИЗ ПРАКТИКИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL CASES</subject></subj-group></article-categories><title-group><article-title>Морфологическая верификация легочного аспергиллеза</article-title><trans-title-group xml:lang="en"><trans-title>MORPHOLOGICAL VERIFICATION OF PULMONARY ASPERGILLOSIS</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тусупбекова</surname><given-names>М. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Tussupbekova</surname><given-names>M. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>100008, г. Караганда, ул. Гоголя, 40</p></bio><bio xml:lang="en"><p>100008, Karaganda city, Gogolya str.; 40</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бакенова</surname><given-names>Р. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Bakеnova</surname><given-names>R. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>010000, г. Астана, ул. Мангилик ел, 80</p></bio><bio xml:lang="en"><p>010000, Astana city, Mangilik el str., 80</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Стабаева</surname><given-names>Л. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Stabayeva</surname><given-names>L. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>100008, г. Караганда, ул. Гоголя, 40</p></bio><bio xml:lang="en"><p>100008, Karaganda city, Gogolya str.; 40</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Кафедра морфологии. НАО «Карагандинский медицинский университет»<country>Казахстан</country></aff><aff xml:lang="en">Department of Morphology, Karaganda medical university NC JSC<country>Kazakhstan</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">РГП «Больница Медицинского центра Управления делами Президента Республики Казахстан»<country>Казахстан</country></aff><aff xml:lang="en">Hospitals of the Medical Center of the Office of the President of the Republic of Kazakhstan RSE<country>Kazakhstan</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>09</day><month>08</month><year>2025</year></pub-date><volume>0</volume><issue>2</issue><fpage>163</fpage><lpage>170</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Тусупбекова М.М., Бакенова Р.А., Стабаева Л.М., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Тусупбекова М.М., Бакенова Р.А., Стабаева Л.М.</copyright-holder><copyright-holder xml:lang="en">Tussupbekova M.M., Bakеnova R.A., Stabayeva L.M.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://medecol.qmu.kz/jour/article/view/1008">https://medecol.qmu.kz/jour/article/view/1008</self-uri><abstract><p>Аспергиллез легких – инфекционное заболевание, вызываемое грибами рода Aspergillus, которое может поражать легочную ткань, обусловливая воспаление, некроз и утрату функции. Это заболевание становится все более актуальным в связи с увеличением числа пациентов с ослабленным иммунитетом, таких как больные с хроническими заболеваниями дыхательных путей. Заболевание может протекать в различных формах (острых, подострых, хронических, инвазивных), что затрудняет диагностику и требует индивидуализированного подхода к лечению. Необходимо проводить дифференциальную диагностику легочной формы аспергиллеза с туберкулезом, саркоидозом, пневмонией (деструктивными формами), опухолевыми процессами и их метастазами.</p><p>В статье приведен клинический случай диссеминированного легочного аспергиллеза у женщины, при котором возникла трудность клинической диагностики патологического процесса без морфологической верификации.</p><p>Представленный клинический случай демонстрирует, что патоморфолог должен проводить тщательную морфологическую верификацию гранулематозного процесса с оценкой клинико-лабораторных данных, результатов лучевой диагностики и дополнительных методов исследования, учитывая особенности гистологической картины при каждом гранулематозном заболевании. Дифференциальная диагностика гранулематозных образований дает возможность при гистологическом исследовании материала торакобиопсии исключить другие виды гранулематоза, в частности, при туберкулезе и саркоидозе. Своевременная морфологическая верификация клинического диагноза позволит выбрать адекватную тактику лечения и оценить прогноз заболевания. Аспергиллез утяжеляет течение основного патологического процесса в связи имммунодефицитным состоянием.</p><p>Аспергиллез легких представляет собой серьёзную угрозу для здоровья, особенно среди пациентов с ослабленным иммунитетом. Раннее выявление и точная диагностика заболевания играют ключевую роль в его успешном лечении.</p></abstract><trans-abstract xml:lang="en"><p>Aspergillosis of the lungs is an infectious disease caused by fungi of the genus Aspergillus, which can affect lung tissue, causing inflammation, necrosis and loss of function. This disease is becoming increasingly relevant due to the increasing number of patients with weakened immune systems, such as patients with chronic respiratory diseases (for example, COPD, asthma, etc.). The disease can occur in various forms, from acute and subacute to chronic and invasive, which makes diagnosis difficult and requires an individualized approach to treatment. Differential diagnosis of the pulmonary form of aspergillosis should be performed with tuberculosis, sarcoidosis, pneumonia (destructive forms), tumor processes and their metastases.</p><p>The article presents a clinical case of disseminated pulmonary aspergillosis in a woman, in which it became difficult to clinically diagnose the pathological process without morphological verification.</p><p>This clinical case shows that a pathologist should carry out a thorough morphological verification of the granulomatous process, taking into account clinical and laboratory data, radiation diagnostics and additional research methods, taking into account the peculiarities of the histological picture in each granulomatous disease. Differential diagnosis of granulomatous formations makes it possible to exclude other types of granulomatosis, in particular in tuberculosis, during histological examination of thoracobiopsy material. Timely morphological verification of the clinical diagnosis will make it possible to choose an adequate treatment strategy and assess the prognosis of the disease. Aspergillosis worsens the course of the underlying pathological process.</p><p>Aspergillosis of the lungs is a serious threat to health, especially among patients with weakened immune systems.</p><p>Early detection and accurate diagnosis of the disease play a key role in its successful treatment.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>гранулематоз</kwd><kwd>гранулематозные болезни</kwd><kwd>аспергиллез</kwd><kwd>гистологическая диагностика</kwd><kwd>морфологическая верификация</kwd></kwd-group><kwd-group xml:lang="en"><kwd>granulomatosis</kwd><kwd>granulomatous diseases</kwd><kwd>aspergillosis</kwd><kwd>histological diagnosis</kwd><kwd>morphological verification</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Гаврисюк В.К., Кривец В.А. Аспергиллез легких: клинические формы, диагностика, лечение. Украинский пульмонологический журнал. 2015; 4: 69-74.</mixed-citation><mixed-citation xml:lang="en">Gavrisjuk V.K., Krivec V.A. Aspergillez legkih: klinicheskie formy, diagnostika, lechenie. Ukrainskij pul'monologicheskij zhurnal. 2015; 4: 69-74.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Лискина И.В., Кузовкова С.Д. Аспергиллома. Международный медицинский журнал. 2011; 4: 41-48.</mixed-citation><mixed-citation xml:lang="en">Liskina I.V., Kuzovkova S.D. Aspergilloma. Mezhdunarodnyj medicinskij zhurnal. 2011; 4: 41-48.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Denning D., Cadranel J., Beigelman C. Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. Eur. Respir. J. 2016; 47: 4568. https://doi.org/10.1183/13993003.00583-2015</mixed-citation><mixed-citation xml:lang="en">Denning D., Cadranel J., Beigelman C. Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. Eur. Respir. J. 2016; 47: 4568. https://doi.org/10.1183/13993003.00583-2015</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Denning D.W., Cadranel J., Beigelman-Aubry C., Ader F., Chakrabarti A., Blot S., Ullmann A.J., Dimopoulos G. Diagnosis and treatment of chronic pulmonary aspergillosis: clinical guidelines of European Society for Clinical</mixed-citation><mixed-citation xml:lang="en">Denning D.W., Cadranel J., Beigelman-Aubry C., Ader F., Chakrabarti A., Blot S., Ullmann A.J., Dimopoulos G. Diagnosis and treatment of chronic pulmonary aspergillosis: clinical guidelines of European Society for Clinical Microbiology and Infectious Diseases and European Respiratory Society. Pulmonologiya. 2016; 26 (6): 657-679. https://doi.org/10.18093/0869-0189-2016-2-6-665-7679</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Microbiology and Infectious Diseases and European Respiratory Society. Pulmonologiya. 2016; 26 (6): 657-679. https://doi.org/10.18093/0869-0189-2016-2-6-665-7679</mixed-citation><mixed-citation xml:lang="en">Gerardi T., Cartellà A., Mombelli M., Christe A., Ogna A. Aspergillus et poumon [Aspergillus and the lung]. Rev. Med. Suisse. 2024; 20 (895): 2126-2129. https://doi. org/10.53738/REVMED.2024.20.895.2126</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Gerardi T., Cartellà A., Mombelli M., Christe A., Ogna A. Aspergillus et poumon [Aspergillus and the lung]. Rev. Med. Suisse. 2024; 20 (895): 2126-2129. https://doi.org/10.53738/REVMED.2024.20.895.2126</mixed-citation><mixed-citation xml:lang="en">Gupta C., Das S., Dar S.A. Chronic pulmonary aspergillosis in patients with post-TB sequelae. Int. J. Tuberc. Lung. Dis. 2024; 28 (12): 600-602. https://doi.org/10.5588/ ijtld.24.0163</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Gupta C., Das S., Dar S.A. Chronic pulmonary aspergillosis in patients with post-TB sequelae. Int. J. Tuberc. Lung. Dis. 2024; 28 (12): 600-602. https://doi.org/10.5588/ijtld.24.0163</mixed-citation><mixed-citation xml:lang="en">Jaggi T.K., Agarwal R., Tiew P.Y., Shah A., Lydon E.C., Hage C.A., Waterer G.W., Langelier C.R., Delhaes L., Chotirmall S.H. Fungal lung disease. Eur. Respir. J. 2024; 64 (5): 2400803. https://doi.org/10.1183/13993003.008032024</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Jaggi T.K., Agarwal R., Tiew P.Y., Shah A., Lydon E.C., Hage C.A., Waterer G.W., Langelier C.R., Delhaes L., Chotirmall S.H. Fungal lung disease. Eur. Respir. J. 2024; 64 (5): 2400803. https://doi.org/10.1183/13993003.008032024</mixed-citation><mixed-citation xml:lang="en">Jenks J.D., Salzer H.J.F., Hoenigl M. Improving the rates of Aspergillus detection: an update on current diagnostic strategies. Expert. Rev. Anti. Infect. Ther. 2019; 17 (1): 39-50. https://doi.org/10.1080/14787210.2018.155805 4</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Jenks J.D., Salzer H.J.F., Hoenigl M. Improving the rates of Aspergillus detection: an update on current diagnostic strategies. Expert. Rev. Anti. Infect. Ther. 2019; 17 (1): 39-50. https://doi.org/10.1080/14787210.2018.1558054</mixed-citation><mixed-citation xml:lang="en">Matsumoto K., Goto M., Kamikokura Y., Takasawa K., Kobayashi N., Aoyama T., Murakami T., Kamikokura M., Ikechi Y., Kawahata T., Tanaka K., Takatori S., Fujishiro D., Okamoto K., Makino Y., Nishikawa Y., Takasawa A. Molecular and ultrastructural morphological analyses of highly metamorphosed Aspergillus fumigatus on human formalin-fixed paraffin-embedded tissue. Med. Mol. Morphol. 2024; 57 (4): 326-332. https://doi.org/10.1007/s00795024-00402-2</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Matsumoto K., Goto M., Kamikokura Y., Takasawa K., Kobayashi N., Aoyama T., Murakami T., Kamikokura M., Ikechi Y., Kawahata T., Tanaka K., Takatori S., Fujishiro D., Okamoto K., Makino Y., Nishikawa Y., Takasawa A. Molecular and ultrastructural morphological analyses of highly metamorphosed Aspergillus fumigatus on human formalin-fixed paraffin-embedded tissue. Med. Mol. Morphol. 2024; 57 (4): 326-332. https://doi.org/10.1007/s00795-024-00402-2</mixed-citation><mixed-citation xml:lang="en">Costa-Pinto R, Bellomo R. COVID-19-associated pulmonary aspergillosis we should take an individualised approach with early treatment too. Intensive Care Med. 2024; 50 (12): 2231-2232. https://doi.org/10.1007/s00134024-07583-5</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Costa-Pinto R, Bellomo R. COVID-19-associated pulmonary aspergillosis we should take an individualised approach with early treatment too. Intensive Care Med. 2024; 50 (12): 2231-2232. https://doi.org/10.1007/s00134024-07583-5</mixed-citation><mixed-citation xml:lang="en">Stepanova A.A. Vasil'eva N.V. Aravijskij R.A. Borzova Ju.V. Jelektronno-mikroskopicheskoe izuchenie aspergilleza legkih cheloveka na primere arhivnogo biopsijnogo materiala. Problemy medicinskoj mikologii. 2014; 16 (3): 70-79.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Степанова А.А. Васильева Н.В. Аравийский Р.A. Борзова Ю.В. Электронно-микроскопическое изучение аспергиллеза легких человека на примере архивного биопсийного материала. Проблемы медицинской микологии. 2014; 16 (3): 70-79.</mixed-citation><mixed-citation xml:lang="en">Степанова А.А. Васильева Н.В. Аравийский Р.A. Борзова Ю.В. Электронно-микроскопическое изучение аспергиллеза легких человека на примере архивного биопсийного материала. Проблемы медицинской микологии. 2014; 16 (3): 70-79.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
