Tuberc Respir Dis.  2013 May;74(5):231-234. 10.4046/trd.2013.74.5.231.

A Case of Endobronchial Aspergilloma Associated with Foreign Body in Immunocompetent Patient without Underlying Lung Disease

• Jung SW
• Kim MW
• Cho SK
• Kim HU
• Lee DC
• Yoon BK
• Jeong JP
• Ko YC

• KMID: 2050892
• DOI: http://doi.org/10.4046/trd.2013.74.5.231

Abstract

Aspergillus causes a variety of clinical syndromes in the lung including tracheobronchial aspergillosis, invasive aspergillosis, chronic necrotizing pulmonary aspergillosis, allergic bronchopulmonary aspergillosis, and aspergilloma. Aspergilloma usually results from ingrowths of colonized Aspergillus in damaged bronchial tree, pulmonary cyst or cavities of patients with underlying lung diseases. There are a few reports on endobronchial aspergilloma without underlying pulmonary lesion. We have experienced a case of endobronchial aspergilloma associated with foreign body developed in an immunocompetent patient without underlying lung diseases. A 59-year-old man is being hospitalized with recurring hemoptysis for 5 months. X-ray and computed tomography scans of chest showed a nodular opacity in superior segment of left lower lobe. Fiberoptic bronchoscopy revealed an irregular, mass-like, brownish material which totally obstructed the sub-segmental bronchus and a foreign body in superior segmental bronchus of the lower left lobe. Histopathologic examinations of biopsy specimen revealed fungal hyphae, characteristic of Aspergillus species.

Keyword

Aspergillosis; Foreign Bodies; Immunocompetence

MeSH Terms

Aspergillosis
Aspergillosis, Allergic Bronchopulmonary
Aspergillus
Biopsy
Bronchi
Bronchoscopy
Colon
Foreign Bodies
Hemoptysis
Humans
Hyphae
Immunocompetence
Invasive Pulmonary Aspergillosis
Lung
Lung Diseases
Thorax

Figure

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  Figure 1 (A) A chest X-ray showed a nodular opacity in left hilar field. (B) A computed tomography scan of chest showed a 2.4×1.8 cm-sized spiculated nodule and surrounding nodular opacities in superior segment of lower left lobe.

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  Figure 2 (A) Fiberoptic bronchoscopy reveals an irregular, mass-like, brownish material which totally obstructed the sub-segmental bronchus in superior segmental bronchus of the lower left lobe. (B) A foreign body was noted in other sub-segmental bronchus quite near the aspergilloma.

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  Figure 3 Histopathologic examination showed numerous hyphae branching with approximately 45° angle, characteristic of Aspergillus species (H&E stain, ×100).

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