Tuberc Respir Dis.  2006 Aug;61(2):157-161.

A Case of Lung Cancer Obscured by Endobronchial Aspergilloma

• Ham HS
• Lee SJ
• Cho YJ
• Jeon KN
• Jeong YY
• Kim HC
• Lee JD
• Hwang YS

Abstract

A 70-year-old man was referred to the department of pulmonology due to blood tinged sputum and an abnormal chest X-ray. The chest X-ray and CT scans revealed a lobulated contour mass-like lesion in the left upper lung field. The bronchoscopic examination showed a whitish and polypoid mass occluding the left upper lobe bronchus. A biopsy specimen from the lesion revealed many aspergillus hyphae. Intravenous and oral itraconozole were administered over a 4 weeks period. Several months later, the size of the mass on chest X-ray increased and a percutaneous lung biopsy revealed a sarcomatoid carcinoma. We reported a case of lung cancer that was obscured by an endobronchial aspergilloma with a review of the relevant literature.

Keyword

Endobronchial aspergilloma; Lung cancer

MeSH Terms

Aged
Aspergillus
Biopsy
Bronchi
Humans
Hyphae
Lung Neoplasms*
Lung*
Pulmonary Medicine
Sputum
Thorax
Tolnaftate
Tomography, X-Ray Computed
Tolnaftate

Figure

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  Figure 1 Initial chest radiograph showed mild cardiomegaly and barbell shaped mass-like opacity in left upper lung field.

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  Figure 2 A CT scan showed multi-lobulated contour and non-enhancing soft tissue mass -like lesion in left upper lobe posterior segment.

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  Figure 3 Bronchoscopic examination showed whitish and polypoid mass occluding left upper lobe apicoposterior segment.

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  Figure 4 Histologic finding of the mass showed numerous branched, septated aspergillus hyphae with adjacent fibrous exudates in PAS stain(× 100).

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  Figure 5 Several months later, the size of mass increased in chest radiograph and CT scan.

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  Figure 6 Immunohistochemical staining showed that a pleomorphic tumor with spindle cells, positive for vimentin, are invading into normal large round pale pink muscle fibers(×400)

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