Clinical manifestations and treatment outcomes of pulmonary aspergilloma.
BACKGROUND
Pulmonary aspergilloma usually results from the ingrowth of colonized Aspergillus from a damaged bronchial tree, a pulmonary cyst, or from the cavities of patients with underlying lung diseases. In the present study, we analyzed the clinical features, diagnostic methods, and managements of 36 patients with pulmonary aspergilloma.


METHODS
Thirty-six patients were diagnosed as having pulmonary aspergilloma at Chung-Ang University Hospital between February 1988 and February 2000. Their medical records were reviewed retrospectively.


RESULTS
The age of patients (median +/- SD) was 53.3 +/- 11.8 years, the male to female ratio was 2.36:1, and the most frequent symptom was hemoptysis, which occurred in 24 patients (65%). The most common underlying disease was pulmonary tuberculosis (81%), and the upper lobes of both lungs were the most frequently involved sites. Nine patients received a chest CT in the prone position and seven of these showed a movable fungus ball. Eleven patients were positive for the precipitin antibody to A. fumigatus. Twenty patients underwent surgical resection, and post-operative complications were reported in seven cases. The post-operative mortality was 5.6% (2/36).


CONCLUSIONS
Pulmonary aspergilloma usually develops in the patients with underlying lung diseases. Resectional lung surgery is considered the mainstay of therapy for pulmonary aspergilloma. However, this operation is associated with significant complications and death in some cases. Therefore, it is necessary to develop reasonable criteria for selection of candidates for such surgery.
Lee
Sang Hoon
SH
Department of Internal Medicine, College of Medicine, Chung-Ang University, Seoul, Korea.
Lee
Byoung Jun
BJ
Jung
Do Young
DY
Kim
Jin Hee
JH
Sohn
Dong Suep
DS
Shin
Jong Wook
JW
Kim
Jae-Yeol
JY
Park
In Won
IW
Choi
Byoung Whui
BW
D000328:Adult; D000368:Aged; D001228:Aspergillosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D001987:Bronchiectasis / Q000150:complications; D003937:Diagnosis, Differential; D005260:Female; D005541:Forced Expiratory Volume; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D008172:Lung Diseases, Fungal / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications*