Clinical Characteristics of Aspergilloma.
- Author:
Ki Up KIM
1
;
Hyo Wook GIL
;
Suk Ho LEE
;
Do Jin KIM
;
Moon Jun NA
;
Soo Taek UH
;
Yong Hoon KIM
;
Choon Sik PARK
Author Information
- Publication Type:Original Article
- Keywords: Aspergilloma; Tuberculosis; Thoracotomy
- MeSH: Alcoholism; Antibodies; Aspergillus; Bronchial Arteries; Bronchiectasis; Colon; Diagnosis; Follow-Up Studies; Hemoptysis; Humans; Incidence; Korea; Lung; Lung Abscess; Lung Diseases; Medical Records; Mortality; Mycobacterium; Postoperative Complications; Radiography; Respiratory Insufficiency; Retrospective Studies; Risk Factors; Thoracotomy; Thorax; Tuberculosis
- From:Tuberculosis and Respiratory Diseases 2002;52(1):46-53
- CountryRepublic of Korea
- Language:Korean
- Abstract: BACKGROUND: Pulmonary aspergilloma is relatively common in korea. It arises from the colonization proliferation of Aspergillus in preexisting lung parenchymal cavities, in particular tuberculosis. The most common s ymptom in this disorder is hemoptysis, which may or may not be massive and life threatening. A routine chest radiography and computed tomography (CT) are the most important diagnostic procedures. A surgical resection of the aspergilloma has recently been recommended, because of the relatively low incidence of postoperative complications than in the past. A more concentrated sample of patients with aspergilloma, who either underwent a thoracotomy or tested positive for aspergillus antibodies, were reviewed. METHOD: The medical records of twenty-two patients with aspergilloma, who had a proven thoracotomy (9 cases), or who tested positive for the diagnostic procedure and/or aspergillus antibodies (13 cases) from January 1995 to December 2000, were reviewed retrospectively. RESULTS: The most common underlying lung disease was a current or old healed tuberculosis, and 3 patients had cultures of mycobacterium other than tuberculosis (MOTT). The mean time until the aspergilloma was detected 5.91 years in the healed tuerculosis cases. The others cases involved a lung abscess, bronchiectasis and without lung disease. The extrapulmonary disease was alcoholism and diabetes. Hemoptysis was most common in 72.7%. A computed tomography (CT) is useful for diagnosis. The right upper lobe, especially the posterior segment, is the most common location. Bronchial artery embolization is ineffective for a long term follow-up. A lobectomy is most common in a thoracotomy, and intra-operative and post-operative complications are rare. During follow-up, the mortality rate, not from the aspergilloma but from respiratory failure, was 13.6%. CONCLUSION: Aspergilloma is a common cavitary lung disease, It mainly arises from tuberculosis, either current or healed, but extra-pulmonary disease including alcoholism or diabetes are other possible risk factors. Their most common problem in aspergilloma is hemoptysis. Surgery has a low risk of post-operative complications and is recommended in relatively preserved lung function or healthy patients. Medical maneuvers including embolization, and the local insertion of certain materials needs to be studied more closely.
