Pulmonary aspergilloma generally arises from colonization of aspergillus in pre-existing lung cavities. Among the predisposing factors, pulmonary tuberculosis, bronchectasies, sarcoidosis and lung tumors are of high prevalence. The majority of the patients were free of symptoms, but if symptomatic haemoptysis was the most common clinical presentation. Fungus ball sign is the hallmark of radiological examination. Pathologic examination is the most accurate diagnostic method. Symptomatic patients especially with haemoptysis need treatment. Emergent surgery is the method of choice, though many successful results have been reported by application of various medical treatments. 13 patients were retrospectively evaluated with definite pathological diagnosis of pulmonary aspergilloma, representing patients admitted to Masih Daneshvari hospital between 1990 and 2000. 7 male (54%) and 6 female (46%) with a mean age of 43 years (ranging from 22 to 60 years) were examined. Eleven patients (85%) were Iranian and 2 (15%) were Afghan. Haemoptysis (92%) was the most common clinical finding and Tuberculosis (70%) was the most common underlying lung disease. Considering radiological examinations only 5 patients (38%) had probable diagnosis of Aspergilloma prior to surgery. All the patients were undergone operation among which the most frequent symptoms indicating surgery was haemoptysis (77%). Left upper lobe (62%) was the most frequent anatomic site of disease. Among the study population, no preoperative or postoperative deaths occurred. Our results confirm that aspergilloma is of high prevalence in Iran. Clinical presentations, epidemiological etiology, radiological and pathologic findings must be considered to make accurate diagnosis and prompt treatment.
Full conference title:
13th Annual Focus on Fungal Infections
- FFI 13th (2003)