Tuberc Respir Dis.  2006 Jul;61(1):60-64.

A Case of Endobronchial Aspergilloma

• Kim SJ
• Lee EJ
• Lee TH
• Yoo KH
• Lee KY

Abstract

Pulmonary aspergillosis presents as the following three different types depending on the immune status of the host: invasive aspergillosis, allergic bronchopulmonary aspergillosis (ABPA), and aspergilloma. Aspergilloma develops as a result of an aspergillus growth inside a pre-existing lung cavity. However, endobronchial aspergilloma without a lung parenchymal lesion is quite rare. We encountered a case of endobronchial aspergilloma that developed in a healthy 75 year-old woman that led to necrotizing pneumonia of the right lower lobe. The chief complaints were fever, cough and yellowish sputum. The chest film revealed haziness with cavity-like shadows on the right lower lobe, and the chest CT scan showed endobronchial calcified density in the basal bronchus of the right lower lobe with peribronchial lymph node enlargement. Bronchoscopy revealed an obstruction of the basal orifice of the right lower lobe by blackish stone-like material, and the aspergilloma was confirmed by the bronchoscopic biopsy. The pneumonia improved after bronchoscopic removal of this lesion. We report this case along with a review of the relevant literature.

Keyword

Endobronchial aspergilloma; Bronchoscopy

MeSH Terms

Aged
Aspergillosis
Aspergillosis, Allergic Bronchopulmonary
Aspergillus
Biopsy
Bronchi
Bronchoscopy
Cough
Female
Fever
Humans
Lung
Lymph Nodes
Pneumonia
Pulmonary Aspergillosis
Sputum
Thorax
Tomography, X-Ray Computed

Figure

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  Figure 1 Initial chest PA shows haziness with cavitylike shadows on the right lower lung field, accompanying with small amount of pleural effusion.

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  Figure 2 A CT scan shows endobronchial calcified density in the right lower lobe basal bronchus with peribronchial lymph node enlargement.

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  Figure 3 RLL basal orifice was obstructed by blackish stone-like material with regional granulation tissue. Removal with elegator was tried but it could not be carbed with brockening.

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  Figure 4 Microscopy shows septated hyphae of Aspergillus with acute angulation (upper, PAS stain ×400), and gross picture shows the removed blackish stone-like material (lower).

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  Figure 5 The infiltration, shown previously on the right lower lung field, was much improved on the follow-up chest PA.

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