title: Clinical course and prognostic factors of pulmonary aspergilloma.
abstract: OBJECTIVE
  There is limited data on size change during natural progression of pulmonary aspergilloma. We aimed at elucidating the clinical course and prognosis of aspergilloma according to its size change.
  
  
  METHODS
  A multicentre retrospective observational study was performed in 143 adult pulmonary aspergilloma patients with serial chest computed tomography images. The clinical course and risk of haemoptysis according to the size change of the cavity or mass of aspergillomas was evaluated.
  
  
  RESULTS
  Median follow-up duration was 5.1 years. The size of aspergillomas changed in 39.2% of study subjects. Decreased and increased volumes of aspergilloma were observed in 13.3% and 25.9%, respectively. Patients with decreased volume had significantly higher C-reactive protein, and more severe bronchiectasis and tuberculosis-destroyed lung. Clinically significant haemoptysis occurred in 50.3% of patients and was significantly associated with the cavity and mass volume of aspergilloma, but not the extent of volume change. A mean cavity diameter of more than 22 mm and a mass diameter of more than 18 mm increased the risk of clinically significant haemoptysis.
  
  
  CONCLUSIONS
  A significant portion of pulmonary aspergilloma changed size in our population. The prevalence of clinically significant haemoptysis was associated with absolute size of cavity and mass of aspergilloma.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jung-Kyu
authors.initials: JK
authors.lastname: Lee
authors.forename: Yeon Joo
authors.initials: YJ
authors.lastname: Lee
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Park
authors.forename: Jong Sun
authors.initials: JS
authors.lastname: Park
authors.forename: Young-Jae
authors.initials: YJ
authors.lastname: Cho
authors.forename: Young Sik
authors.initials: YS
authors.lastname: Park
authors.forename: Ho Il
authors.initials: HI
authors.lastname: Yoon
authors.forename: Choon-Taek
authors.initials: CT
authors.lastname: Lee
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D001987:Bronchiectasis / Q000453:epidemiology*; D002097:C-Reactive Protein / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D006469:Hemoptysis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D055732:Pulmonary Aspergillosis / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000473:pathology*
chemical_list: D002097:C-Reactive Protein
keywords: fungal; haemoptysis; lung disease; mycetoma; pulmonary aspergillosis