title: A Series of Transbronchial Removal of Intracavitary Pulmonary Aspergilloma.
abstract: BACKGROUND
  Intracavitary pulmonary aspergilloma is a chronic, debilitating fungal infection. Without definitive therapy, death can occur from massive hemoptysis, cachexia, or secondary infection. Although surgical resection is the standard therapy, it is not possible for many patients owing to poor pulmonary function or medical comorbidities. Aspergilloma removal through bronchoscopy is an important alternative therapy that may be available in select cases.
  
  
  METHODS
  We retrospectively reviewed all cases referred to the University of Calgary Interventional Pulmonary Service for transbronchial removal of intracavitary aspergilloma from January 1, 2009, to January 1, 2014.
  
  
  RESULTS
  Ten patients with intracavitary pulmonary aspergilloma were identified. In 3 patients, the aspergilloma cavity was not accessible by bronchoscopy. Successful removal of the aspergilloma with symptom improvement or resolution was achieved in 6 of 7 cases. One of the patients was lost to follow-up. Minor hypoxia lasting 12 to 72 hours was observed in 5 cases. Severe sepsis requiring an extended critical care unit stay occurred in 1 case. Follow-up ranged from 9 months to 5 years.
  
  
  CONCLUSIONS
  Although not without risk of minor hypoxia and possible sepsis, for carefully selected patients, bronchoscopic removal of symptomatic intracavitary pulmonary aspergilloma may be an alternative therapy to surgical resection for this life-threatening disease.
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: David R
authors.initials: DR
authors.lastname: Stather
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Alain
authors.initials: A
authors.lastname: Tremblay
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address: elaine.dumoulin@albertahealthservices.ca.
authors.forename: Elaine
authors.initials: E
authors.lastname: Dumoulin
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: MacEachern
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Alex
authors.initials: A
authors.lastname: Chee
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Hergott
authors.affiliation: Department Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Jacob
authors.initials: J
authors.lastname: Gelberg
authors.affiliation: Department of Surgery, Immunology and Infectious Disease, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Gelfand
authors.affiliation: Department of Radiology, Immunology and Infectious Disease, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Burrowes
authors.affiliation: Department of Radiology, Immunology and Infectious Disease, University of Calgary, Calgary, Alberta, Canada.
authors.forename: John H
authors.initials: JH
authors.lastname: MacGregor
authors.affiliation: Department of Microbiology, Immunology and Infectious Disease, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Mody
mesh_terms: D000328:Adult; D000368:Aged; D000416:Alberta; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D018579:Patient Selection; D055732:Pulmonary Aspergillosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome