Aspergilloma

Case contributed by Dr Sajoscha Sorrentino

Presentation

Patient was admitted with acute renal failure and received an x-ray of the thorax in the course of examination. Patient had no pulmonary symptoms.

Patient Data

Age: 75 years
Gender: Male
X-ray

Chest x-ray

A densitiy in the right upper zone is present with clear evidence of volume loss (the trachea and mediastinum are pulled towards the right, and the hilum is elevated). 

At the inferior margin of the central opacity there appears to be a lucent line.

CT

On the CT scan the right upper lobe density had the classical appearance of an aspergilloma: a well formed cavity with a central soft tissue attenuating rounded mass surrounded by an air crescent sign.

Annotated image

Annotated images

Zoomed cropped images of the chest x-ray and CT elegantly show the cavity partially filled with debris/mass. Between the mass and the wall of the cavity a crescent of air is present (blue arrows). 

Histology

Histology revealed fibrinous, putrid inflammation due to massive fungal infection with Aspergillus fumigatus.

Case Discussion

Aspergilloma is the most common manifestation of aspergillosis and is seen in patients with normal humoral immunity but with cavities in the lung (typically due to TB). 

Fungal mycelia conglomerate in pre-formed cavities (e.g. cyts, caverns, bronchiectases) to a fungus ball (so called mycetoma).

PlayAdd to Share

Case information

rID: 14842
Case created: 30th Aug 2011
Last edited: 8th Nov 2017
System: Chest
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.