Purpose
Aspergilloma often develops in a preexistent cavity or bronchiectasis.
Tuberculosis,
sarcoidosis,
emphysema,
lung cysts (especially Langerhans cell histiocytosis),
cavitated tumor,
and pulmonary infarction.
Any cavity or cystic space created by underlying pulmonary disease can,
theoretically,
harbor aspergilloma.
However,
studies of the association between aspergilloma and honeycomb cysts are very rare [1-3].
Herein,
we aimed to emphasize the computed tomography (CT) findings of Aspergilloma in chronic hypersensitivity pneumonitis related honeycomb cysts.
Methods & Materials
A 54-year-old female patient was presented to the chest disease department with complaints of cough,
weakness and expectoration for two-months.
The patient denied fever or hemoptysis.
The patient had occupational history as a farmworker and she had been diagnosed with subacute hypersensitivity pneumonitis (HP) 6 years ago and treated with prednisolone (8 mg / day).
She had no history of smoking or malignancy.
Physical examination revealed oxygen saturation as 85% on room air,
bibasilar Velcro crackles and normal body temperature (36.8oC).
Laboratory test results (including...
Results
A chest x-ray was obtained and showed bilateral reticulonodular opacities in the both middle and lower zones (Figure 1).
The patient underwent high-resolution computed tomography (HRCT) and HRCT showed honeycomb cysts and traction bronchiectasis in both lung,
predominantly upper lobe anterior and lower lobe basal segments.
Dependent soft tissue densities were present in some of the honeycomb cysts (Figure 2).
Then,
HRCT procedure was repeated in the prone position and revealed that filling defects in the honeycomb cysts showed dependent distribution by gravity (Figure 3)....
Conclusion
The presence of intracavitary nodule replaced by the patient's position on computed tomography strongly indicates the diagnosis of aspergilloma,
as in our case.
References
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Franquet,
N.L.
Mñ/4ller,
A.
Gimèc)nez,
P.
Guembe,
J.
de La Torre,
S.
Baguèc) Spectrum of pulmonary aspergillosis: histologic,
clinical,
and radiologic findings Radiographics,
21 (2001),
pp.
825-837
[2] M.A.
Dar,
M.
Ahmad,
A.J.
Weinstein,
A.C.
Mehta,
J.A.
Golish Thoracic aspergillosis (Part I).
Overview and aspergilloma Cleve Clin Q,
51 (1984),
pp.
615-630
[3] Louza GF,
Zanetti G,
Marchiori E.
Aspergilloma in Honeycomb Cysts and Paraseptal Emphysema: An Unusual Association.
Arch Bronconeumol.
2018 Feb;54(2):110-111.
Personal Information
Furkan UFUK,
MD,
TBR.
Pamukkale University,
Faculty of Medicine
Department of Radiology
Denizli/Turkey
[email protected]