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We report such a case in a 68\u2010year\u2010old male with a history of metastatic prostate adenocarcinoma and longstanding chronic obstructive pulmonary disease who presented with features of pneumonia. BAL revealed Aspergillus and parainfluenza infections, food particle aspiration pneumonia, as well as metastatic prostatic adenocarcinoma. The food particles were initially confused for yeast infection, but we finally identified them as nut products. This may be the first documented case of nut product aspiration diagnosed on BAL. The potential pitfalls that may complicate the evaluation are also discussed.<\/jats:p>","DOI":"10.1002\/dc.24327","type":"journal-article","created":{"date-parts":[[2019,10,22]],"date-time":"2019-10-22T16:10:20Z","timestamp":1571760620000},"page":"144-148","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Unusual trifecta of infections, aspiration, and metastatic prostatic adenocarcinoma in a bronchoalveolar lavage specimen"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1329-1586","authenticated-orcid":false,"given":"Brant G.","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Pathology Inova Fairfax Hospital  Falls Church Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haresh","family":"Mani","sequence":"additional","affiliation":[{"name":"Department of Pathology Inova Fairfax Hospital  Falls Church Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe Q.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology Inova Fairfax Hospital  Falls Church Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zacharia","family":"Nayer","sequence":"additional","affiliation":[{"name":"George Washington School of Medicine and Health Sciences  Washington District of Columbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jawad","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Inova Loudon Hospital  Leesburg Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,10,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781444346428"},{"key":"e_1_2_6_3_1","first-page":"796","article-title":"Bronchoalveolar lavage in the cytologic diagnosis of carcinoma of the 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