Case contributed by Bruno Di Muzio
Diagnosis almost certain


Previous history of pulmonary tuberculosis and normal immunity.

Patient Data

Age: 70
Gender: Male

Chest X-ray


Rounded soft tissue attenuating masses within cavities in the upper zones. Signs of scaring in both lung apices likely related to previous infections. 

CT Chest (selected images)


Scarring and rounded soft tissue attenuating masses within cavities in the upper zones. 

Annotated image

Magnified view of the chest radiograph depicting the "air-crescent" sign of a soft tissue mass within a pre-existing cavity.  

Case Discussion

An aspergilloma is a mycetoma (mass-like fungus ball) typically composed of Aspergillus fumigatus, and is a non-invasive form of pulmonary aspergillosis.

This case was not confirmed with microbiology and the diagnosis was based only on clinical history and imaging findings, although the imaging features are very typical. 

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