Subacute invasive pulmonary and pleural aspergillosis and lung cancer

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This 63 year old Caucasian male with history of emphysema was diagnosed with right upper lobe (RUL) non-small cell lung cancer (NSCLC) and underwent a RUL resection in June 1997. Three months later, he had recurrence of NSCLC to chest wall, necessitating further resection, XRT, and chemotherapy. He had emphysema and dyspnea at baseline. By the end of October 1999 pulmonary aspergillosis/empyema was diagnosed (based on lung and pleural tissue histology and culture). His disease was initially refractory to Amphotericin B deoxycholate (faiIure to improve). He was treated thereafter with caspofungin for 70 days with partial response.