Aspergillus in Pap smears
A cytology thread documented Aspergillus fumigatus on Pap smears—uniform septate hyphae with acute-angle branching and terminal vesicles, often with inflammation and giant cells, and PAS stain utility noted. The case was shared as an educational post by a certified lab manager (Mar 20). (x.com)
A 2017 literature review concluded that finding Aspergillus in cervicovaginal Pap smears is uncommon and that every such finding should prompt confirmation by culture to distinguish contamination from true infection. (medcraveonline.com) A recent conventional cytology series examined 4,496 smears and reported Candida in 523 cases while only 18 slides showed unusual environmental fungal contaminants such as Penicillium and Alternaria, underscoring how rare non‑Candida molds are in routine GYN cytology. Published case reports describe primary cervical Aspergillus identified on cytology in patients aged 52, 55 and 57 years, with at least one case proceeding to biopsy and antifungal therapy and another showing resolution on a post‑treatment smear. Documented laboratory contamination has included recovery of Aspergillus fumigatus from wooden spatula sampling devices, and repeat smears using sterilized instruments have eliminated the organism from subsequent preparations in reported cases. Cytopathology guidance recommends triaging suspected fungal findings for dedicated fungal culture and adjunct testing, and the U.S. CDC’s Antimicrobial Resistance Lab Network asks clinical labs to submit Aspergillus fumigatus isolates for azole‑resistance surveillance via regional PHLs in Maryland and Tennessee. Multiple reviews advise documented communication with the clinician and, when indicated, targeted biopsy or repeat specimen collection before initiating systemic antifungal therapy or surgical planning to avoid unnecessary treatment based on a contaminated smear.
