Massive Hemoptysis with a Fungus Ball-like Shadow in an Old Tuberculosis Cavity That Was Shown to Be a Clot by Bronchoscopy

Intern Med. 2018 Feb 1;57(3):377-381. doi: 10.2169/internalmedicine.8967-17. Epub 2017 Nov 1.

Abstract

Development of aspergilloma is common in cases with a fungus ball-like shadow in cavities due to old tuberculosis. Some reports have shown that blood clots tend to appear as a fungus ball-like shadow. A 71-year-old man with a history of pulmonary tuberculosis presented with a fungus ball-like shadow in an old cavity and hemoptysis. There was no evidence of aspergillus infection on various examinations. We confirmed a blood clot and aneurysm of an artery under direct vision by bronchoscopy. A lateral thoracic artery aneurysm was detected by angiography. Transcatheter arterial embolization was performed. After treatment, the artery aneurysm disappeared.

Keywords: Hemoptysis; aspergilloma; blood clot; fungus ball-like shadow; lateral thoracic artery aneurysm.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aneurysm / diagnostic imaging*
  • Aneurysm / surgery
  • Angiography
  • Bronchoscopy
  • Embolization, Therapeutic
  • Foreign Bodies / diagnostic imaging
  • Foreign Bodies / surgery*
  • Fungi
  • Hemoptysis / diagnosis*
  • Hemoptysis / surgery*
  • Humans
  • Male
  • Pulmonary Aspergillosis / complications*
  • Pulmonary Aspergillosis / diagnostic imaging*
  • Thrombosis / diagnostic imaging*
  • Thrombosis / surgery
  • Treatment Outcome