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- Title
Diagnosis of aspergilloma in a pleural cavity (persistent pneumothorax) using classic imaging methods.
- Authors
Kreymborg, Karsten Grosse; Seyfarth, Hans-Jürgen; Gessner, Christian; Schütz, Alexander; Hammerschmidt, Stefan; Eichfeld, Ulrich; Borte, Gudrun; Wirtz, Hubert
- Abstract
The diagnosis of pulmonary aspergillosis is based on serum-analysis, as well as histological and microbiological analysis of bronchial lavage and transbronchial biopsies. When Aspergillus develops within a preformed cavity, however, these tests are likely to be negative. In this situation, classic imaging techniques such as chest X-ray and high resolution-computed tomography (HR-CT) can be of great diagnostic use. We here describe the case of a 62-year-old woman with a history of breast cancer and subsequent ablation of the left breast and radiotherapy. The case demonstrates an example of a pleuropulmonary aspergilloma, in which sero- and micro-biological detection failed. Thorax HR-CT exhibited the cavity, a small persistent pneumothorax, partially filled by an oval density. This density clearly dislocated according to gravity following a positional change of the patient from supine to prone. The density thus revealed mobility which was typical of aspergilloma. Following excision, this diagnosis was confirmed. A density within a cavity may be differentiated by its mobility from differential diagnoses such as lung cancer which would not be expected to exhibit mobility.
- Subjects
PULMONARY aspergillosis; FUNGAL lung diseases; BRONCHOALVEOLAR lavage; BREAST cancer; PNEUMOTHORAX; LUNG cancer
- Publication
Mycoses, 2006, Vol 49, Issue 3, p210
- ISSN
0933-7407
- Publication type
Article
- DOI
10.1111/j.1439-0507.2006.01236.x