Korean J Intern Med.  2004 Mar;19(1):38-42.

Clinical Manifestations and Treatment Outcomes of Pulmonary Aspergilloma

• Lee SH
• Lee BJ
• Jung DY
• Kim JH
• Sohn DS
• Shin JW
• Kim JY
• Park IW
• Choi BW

Abstract

BACKGROUND
Pulmonary aspergilloma usually results from the ingrowth of colonized Aspergillus from a damaged bronchial tree, a pulmonary cyst, or from the cavities of patients with underlying lung diseases. In the present study, we analyzed the clinical features, diagnostic methods, and managements of 36 patients with pulmonary aspergilloma. METHODS: Thirty-six patients were diagnosed as having pulmonary aspergilloma at Chung-Ang University Hospital between February 1988 and February 2000. Their medical records were reviewed retrospectively. RESULTS: The age of patients (median +/- SD) was 53.3 +/- 11.8 years, the male to female ratio was 2.36: 1, and the most frequent symptom was hemoptysis, which occurred in 24 patients (65%). The most common underlying disease was pulmonary tuberculosis (81%), and the upper lobes of both lungs were the most frequently involved sites. Nine patients received a chest CT in the prone position and seven of these showed a movable fungus ball. Eleven patients were positive for the precipitin antibody to A. fumigatus. Twenty patients underwent surgical resection, and post-operative complications were reported in seven cases. The post-operative mortality was 5.6% (2/36). CONCLUSION: Pulmonary aspergilloma usually develops in the patients with underlying lung diseases. Resectional lung surgery is considered the mainstay of therapy for pulmonary aspergilloma. However, this operation is associated with significant complications and death in some cases. Therefore, it is necessary to develop reasonable criteria for selection of candidates for such surgery.

Keyword

Aspergilloma; Pulmonary tuberculosis; Hemoptysis

MeSH Terms

Adult
Aged
Aspergillosis/complications/*diagnosis/therapy
Bronchiectasis/complications
Diagnosis, Differential
Female
Forced Expiratory Volume
Hemoptysis/etiology
Human
Lung Diseases, Fungal/complications/*diagnosis/therapy
Male
Middle Aged
Postoperative Complications/mortality
Retrospective Studies
Treatment Outcome
Tuberculosis, Pulmonary/*complications