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Air crescent sign (aspergilloma)

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

History withheld.

Patient Data

Age: 20 years
Gender: Female

Chest x-ray

x-ray

PA chest x-ray demonstrates a rounded density in the right midzone with an air crescent. 

CT chest

ct

CT of the chest demonstrates a nodule with peripheral ground glass opacity. The central component is retracting away from the rest of the region with the formation of an air crescent. 

Case Discussion

This patient is neutropaenic but has improving cell counts. The development of an air crescent sign in the setting of angioinvasive aspergillosis is a good prognostic sign, denoting separation of the infarcted core from host response / granulation tissue. 

This should not be confused with an aspergilloma which occurs in patients with normal immunity and represents colonization by aspergillus of a previously existing cavity (most commonly TB). 

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