CT-guided percutaneous treatment of inoperable pulmonary aspergillomas: a study of 40 cases.
OBJECTIVE
To treat symptomatic pulmonary aspergilloma in patients who were not considered to be operable.


METHODS
Forty patients were treated by CT-guided percutaneous injection of amphotericin paste, the aim being to fill the cavity completely and create an anaerobic environment for the aspergillus. The aspergillomas had developed after bacillary infection and pulmonary fibrosis. Surgery was contra-indicated in these patients because of severe respiratory failure. The authors detail the method of preparation of the paste and the technique of percutaneous injection.


RESULTS
Hemoptysis ceased in all 40 patients, with a follow-up ranging from 6 to 28 months; six patients were also treated with bronchial embolization. In 26 patients, the aspergilloma disappeared and serum tests for aspergillus became negative. Complete disappearance of both the aspergilloma and the cavity was obtained in three patients.


CONCLUSIONS
This technique appears to be a valuable contribution to non-surgical treatment of inoperable patients with pulmonary aspergilloma, but study should be continued in a larger series to define the exact indications and the interaction with other treatments which have recently been introduced.
Giron
J
J
Department of Radiology, Purpan University Hospital, Toulouse, France.
Poey
C
C
Fajadet
P
P
Sans
N
N
Fourcade
D
D
Senac
J P
JP
Railhac
J J
JJ
D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage* / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001228:Aspergillosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D009824:Ointments; D010166:Palliative Care / Q000379:methods; D014057:Tomography, X-Ray Computed
D000935:Antifungal Agents; D009824:Ointments; D000666:Amphotericin B