Fungus ball diagnosed on computed tomography (CT) guided needle biopsy of thoracic lesions

Mehrdad Bakhshayesh, Pooyeh Graili, Soheyla Zahirifard.

Author address: 

Radiology Department, National Research Institute of Tuberculosis and Lung Diseaes, Tehran, Islamic Republic of Iran


Background: CT-guided biopsy provides results in a short period and can be applied on outpatient and even high risk patients however; some studies do not recommend it in lesions with benign histology probability Objectives: To report our experience regarding fungus ball diagnosis on CT-guided biopsy and to identify the complication rate of procedure. Materials and methods: We evaluated 99 CT-guided biopsies of infected thoracic lesions performed from March 2004 to December 2008, retrospectively. All biopsies were performed by one radiologist by westcott needle number 20 and 18. The CTs were assessed by a trained general practitioner for the size and location of lesions and pneumothorax or pneumomediastinum diagnosis and then all CTs were double checked by the same radiologist. Lesions considered fungus and their differentiations based on pathology reports. Results: During four year study 20 fungus lesions (15 male and 5 female) were found with the mean age 54.75 years (ranging: 19-77). In these series there were 16 (80%) Aspergillosis, 2 (10%) Mucor mycosis and 2 undifferentiated fungus bal. The mean diameter of lesions and lesion distance to chest wall were 5.650 cm (range: 1 to 11.5) and 0.75 cm (range: 0 to 3), respectively. Nine (45%) fungus lesions were located in left upper, 4 (20%) in right lower, 4 (20%) in right upper and the rest (15%) in left lower and right middle lobes. Pneumothorax occurred in 2 cases (1 Aspergillosis and 1 Mucor mycosis) while chest tube was placed only for patient with Mucor mycosis to manage the complication. Conclusion: CT-guided needle biopsy seems to be safe and feasible diagnostic modality with low risk probability of complications for fungus balls.

abstract No: 


Full conference title: 

European Respiratory Congress
    • ERS 21st (2011)