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Aspergilloma

Case contributed by: Dr Naeem Jagirdar

Presentation:

84 yr old female smoker with previous history of breast cancer, presenting with fever and increasing breathlessness on a background of COPD.

From the case: Aspergilloma

Modality: CT

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Air cresent sign/Aspergillosis.

Aspergillosis commonly seen in immunocompromised patients. On CT aspergilloma is characterized by a mass with soft-tissue attenuation within a lung cavity. The mass is typically separated from the cavity wall by an airspace - air crescent sign and is often associated with thickening of the wall and adjacent pleura.

Case Discussion:

Chest x-ray and CT of the chest demonstrates a cavity in the apex of the left lung, with a central soft tissue attenuation mass surrounded by air (Monod sign). There is aslo thickening of the wall and adjacent pleura.

Features are consistent with an aspergilloma, presumably occupying a pre-existing cavity due to COPD or prior tuberculosis.