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KMID : 0383819850320030211
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Tuberculosis and Respiratory Diseases
1985 Volume.32 No. 3 p.211 ~ p.215
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Solitary Pulmonary Nodule with Recurrent Hemoptysis
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손희영/Hee Young Sohn
박해심/이강석/허미/김성규/김기호/Hae Sim Park/Kang Suk Lee/Mi Hur/Sung Kyu Kim/Ki Ho Kim
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Abstract
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A mycetoma is a mass of intertwinged fungal hyphae within a pulmonary cavity. It
may be the result of colonization of Candida or by other fungal species. However the
most common invader is Aspergillus. The most common underlying causes of the cavity
are tuberculosis and then sarcoidosis, bronchiectasis, emphysematous bullae, bronchial
cyst, pulmonary infarct, lung abscess, hematologic malignancies and prolonged use of
corticosteroid or antibiotics. Chest tomogram taken in the upright position provide the
best in subjects of the Aspergilloma and of the surrounding air-crescent. The major
clinical problem associated with Aspergilloma is pulmonary hemorrhage. Surgical
excision is the only effective treatment and should be utilized after a second bout of
severe hemorrhage in the patient who has unilateral diseases with a single obvious
Aspergilloma, and who has no major impairment of pulmonary function.
A 28 year-old housewife was admitted with many bouts of mild to moderate amount
of hemoptysis. There was no history of previous bronchopulmonary disease and any
clinical and laboratory evidence of active pulmonary tuberculosis. Roentgenogram of her
chest showed ovoid homogenous mass without cavity or air-crescent in left upper lobe.
Sputum examinations for tubercle bacilli, malignant cell and Aspergillus culture were all
negative. Serologic test(immunodiffusion method) for Aspergillosis was negative.
Anti-tuberculous therapeutic trial yielded no alteration of the symptoms and
roentgenographic feature. Left upper lobectomy was performed, and the specimen
removed was found to contain 2×3㎝ sized ovoid mass surrounded by lung parenchyme.
Its cross section showed cheese-like material. Microscopic examination revealed fungal
mycelia of Aspergillus species.
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KEYWORD
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