Clinical investigation of pulmonary aspergilloma

Lee, Sang Hoon; Lee, Byoung Jun; Jung, Do Young; Kim, Jin Hee; Sohn, Dong Suep; Shin, Jong Wook; Kim, Jae Yeol; Park, In Won; Choi, Byoung Whui

Abstract

BACKGROUND: Pulmonary aspergilloma usually results from the ingrowth of the colonized Aspergillus in the damaged bronchial tree, pulmonary cyst, or cavities of patients with underlying lung diseases. We analyzed the clinical features, diagnostic methods, and managements of 36 patients with pulmonary aspergilloma.
METHODS
From February 1988 to February 2000, medical records of 36 patients who were diagnosed as pulmonary aspergilloma at Chung Ang university hospital were reviewed retrospectively.
RESULTS
The mean age (mean+/-SD) was 53.3+/-11.8 years, The male to female ratio was 2.36:1. The most frequent symptom was hemoptysis which occured in 24 patients (65%). The most common underlying disease was pulmonary tuberculosis (81%). The upper lobe was most commonly involved area. In 9 patients, chest CT was taken with prone position and 7 of them showed movability of the fungus ball. Eleven patients showed positive test for precipitin antibody of Aspergillus species. As for the treatment, 20 patients underwent surgical resection. Post-operative complications were reported in 7 cases. The post-operative mortality was 5.6% (2/36).
CONCLUSION
Pulmonary aspergillomas usually develop in patients with underlying respiratory diseases. Resectional lung surgery is considered to be the mainstay of therapy for pulmonary aspergilloma. However, operation is associated with significant complication rate and even deaths. Therefore, it is necessary to develop a reasonable criteria for the selection of suitable candidates with aspergilloma for the surgery.