title: Chronic fibrosing pulmonary aspergillosis: a cause of 'destroyed lung' syndrome.
abstract: BACKGROUND
  Chronic pulmonary aspergillosis (CPA) has substantial impact on quality of life. A subset of patients develops significant pulmonary fibrosis, identified either on biopsy or radiologically. The term chronic fibrosing pulmonary aspergillosis (CFPA) has been suggested.
  
  
  METHODS
  We describe 11 patients with CFPA referred to our centre.
  
  
  RESULTS
  Mean age was 58.5 years and five were male. In nine, fibrosis was already evident on presentation, while in two it developed 3 and 6 years later. The predominant radiological feature was extensive or complete involvement of the entire lung, with minimal contralateral involvement. All patients received prolonged antifungal treatment. Two patients had surgical treatment; both developed post-operative complications. The contralateral lung remained free of significant disease in all but three patients.
  
  
  CONCLUSIONS
  CFPA is a rare complication of CPA that is usually evident on presentation, but may develop after years in patients not on antifungals. Fibrosis resembles the 'destroyed lung' syndrome described after treated tuberculosis.
authors.affiliation: a National Aspergillosis Centre, Manchester Academic Health Science Centre , University Hospital of South Manchester, University of Manchester , Manchester , UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Kosmidis
authors.affiliation: a National Aspergillosis Centre, Manchester Academic Health Science Centre , University Hospital of South Manchester, University of Manchester , Manchester , UK.
authors.forename: Pippa
authors.initials: P
authors.lastname: Newton
authors.affiliation: a National Aspergillosis Centre, Manchester Academic Health Science Centre , University Hospital of South Manchester, University of Manchester , Manchester , UK.
authors.forename: Eavan G
authors.initials: EG
authors.lastname: Muldoon
authors.affiliation: a National Aspergillosis Centre, Manchester Academic Health Science Centre , University Hospital of South Manchester, University of Manchester , Manchester , UK.
authors.forename: David W
authors.initials: DW
authors.lastname: Denning
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D005355:Fibrosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D055732:Pulmonary Aspergillosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: Chronic pulmonary aspergillosis; case series; destroyed lung; fibrosis; outcome; radiology