A Case of Allergic Bronchopulmonary Aspergillosis Forming Broncholith Misdiagnosed as an Uncontrolled Asthma with Broncholithiasis.
- Author:
Chi Young KIM
1
;
Moo Suk PARK
;
Young Sam KIM
;
Joon CHANG
;
Se Kyu KIM
;
Kyung Soo CHUNG
Author Information
1. Division of Pulmonology, Department of Internal Medicine, The Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea. chungks@yuhs.ac
- Publication Type:Case Report
- Keywords:
Allergic bronchopulmonary aspergillosis;
Broncholithiasis;
Asthma
- MeSH:
Aspergillosis, Allergic Bronchopulmonary*;
Aspergillus;
Asthma*;
Bronchi;
Bronchiectasis;
Cough;
Diagnosis;
Eosinophils;
Exudates and Transudates;
Female;
Humans;
Hyphae;
Middle Aged;
Pulmonary Medicine;
Respiratory Sounds;
Spores;
Sputum;
Thorax
- From:Soonchunhyang Medical Science
2015;21(2):146-149
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 55-year-old woman was referred to the division of pulmonology at Severance Hospital for the investigation of uncontrolled asthma with recurrent cough at night, blood-tinged sputum, malaise, and wheezing since 3 months. Chest computed tomography revealed bronchiectasis and broncholithiasis in the lateral segmental bronchus of the right middle lobe and the anterobasal segmental bronchus of the right lower lobe. Bronchoscopic broncholith removal was performed because of recurrent blood-tinged sputum and the outflow of purulent exudate behind the broncholith in the lateral segmental bronchus of the right middle lobe. The extracted material presenting amorphous eosinophilic necrotic materials with calcification was compatible with broncholithiasis. Following decalcification, histopathology revealed degenerated septate fungal hyphae and spores that were morphologically consistent with Aspergillus spp. A final diagnosis was allergic bronchopulmonary aspergillosis (ABPA) forming broncholith. The results from this case suggest that the early recognition of ABPA should be considered in patients with uncontrolled asthma accompanied by broncholithiasis.
