Soonchunhyang Med Sci.  2015 Dec;21(2):146-149. 10.0000/sms.2015.21.2.146.

A Case of Allergic Bronchopulmonary Aspergillosis Forming Broncholith Misdiagnosed as an Uncontrolled Asthma with Broncholithiasis

• Kim CY
• Park MS
• Kim YS
• Chang J
• Kim SK
• Chung KS

• KMID: 2317777
• DOI: http://doi.org/10.0000/sms.2015.21.2.146

Abstract

A 55-year-old woman was referred to the division of pulmonology at Severance Hospital for the investigation of uncontrolled asthma with recurrent cough at night, blood-tinged sputum, malaise, and wheezing since 3 months. Chest computed tomography revealed bronchiectasis and broncholithiasis in the lateral segmental bronchus of the right middle lobe and the anterobasal segmental bronchus of the right lower lobe. Bronchoscopic broncholith removal was performed because of recurrent blood-tinged sputum and the outflow of purulent exudate behind the broncholith in the lateral segmental bronchus of the right middle lobe. The extracted material presenting amorphous eosinophilic necrotic materials with calcification was compatible with broncholithiasis. Following decalcification, histopathology revealed degenerated septate fungal hyphae and spores that were morphologically consistent with Aspergillus spp. A final diagnosis was allergic bronchopulmonary aspergillosis (ABPA) forming broncholith. The results from this case suggest that the early recognition of ABPA should be considered in patients with uncontrolled asthma accompanied by broncholithiasis.

Keyword

Allergic bronchopulmonary aspergillosis; Broncholithiasis; Asthma

MeSH Terms

Aspergillosis, Allergic Bronchopulmonary*
Aspergillus
Asthma*
Bronchi
Bronchiectasis
Cough
Diagnosis
Eosinophils
Exudates and Transudates
Female
Humans
Hyphae
Middle Aged
Pulmonary Medicine
Respiratory Sounds
Spores
Sputum
Thorax