Endobronchial aspergilloma: report of 10 cases and literature review

Yonsei Med J. 2011 Sep;52(5):787-92. doi: 10.3349/ymj.2011.52.5.787.

Abstract

Purpose: A retrospective investigation of the clinical and radiologic features as well as the bronchoscopic appearance was carried out in patients with endobronchial aspergilloma.

Materials and methods: Ten patients with endobronchial aspergilloma diagnosed by bronchoscopy and histological examination were identified at the Gyeongsang University Hospital of Korea, from May 2003 to May 2009.

Results: The patients included 9 men and 1 woman, and the age of the patients ranged from 36 to 76 (median, 58 years). The associated diseases or conditions were: previous pulmonary tuberculosis in 7 patients, lung cancer in 2 patients, pulmonary resection in 1 patient, and foreign body of the bronchus in 1 patient. The chest radiologic finding showed fibrotic changes as a consequence of previous tuberculosis infection in 6 patients and a mass-like lesion in 2 patients. Two patients had a co-existing fungus ball, and an endobronchial lesion was suspected in only 2 patients on the CT scan. The bronchoscopic appearance was a whitish to yellow necrotic mass causing bronchial obstruction in 7 patients, foreign body with adjacent granulation tissue and whitish necrotic tissue in 1 patient, whitish necrotic tissue at an anastomosis site in 1 patient, and a protruding mass with whitish necrotic tissue in 1 patient.

Conclusion: An endobronchial aspergilloma is a rare presentation of pulmonary aspergilosis and is usually incidentally found in immunocompetent patients with underlying lung disease. It usually appears as a necrotic mass causing bronchial obstruction on bronchoscopy and can be confirmed by biopsy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Bronchi / pathology
  • Bronchography
  • Bronchoscopy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Aspergillosis / diagnosis*
  • Pulmonary Aspergillosis / diagnostic imaging
  • Pulmonary Aspergillosis / pathology
  • Republic of Korea
  • Retrospective Studies