Clinical Manifestations and Treatment Outcomes of Pulmonary Aspergilloma.
- Author:
Sang Hoon LEE
1
;
Byoung Jun LEE
;
Do Young JUNG
;
Jin Hee KIM
;
Dong Suep SOHN
;
Jong Wook SHIN
;
Jae Yeol KIM
;
In Won PARK
;
Byoung Whui CHOI
Author Information
1. Department of Internal Medicine, College of Medicine, Chung-Ang Univeristy, Seoul, Korea. jykimmd@hananet.net
- Publication Type:Original Article
- Keywords:
Aspergilloma;
Pulmonary tuberculosis;
Hemoptysis
- MeSH:
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
- From:The Korean Journal of Internal Medicine
2004;19(1):38-42
- CountryRepublic of Korea
- Language:English
-
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.
