Presentation
Patient with history of tuberculosis infection a long time ago. Former smoker.
Patient Data
Diffuse parenchymal paraseptal and centrilobular emphysema blebs associated with scars, bronchiectasis, and calcified pulmonary nodules. There is a large cavitation on left lung apex within which there is a rounded soft tissue mass surrounded by an air crescent sign.
Previous CT shows the same cicatricial changes and the cavitation with a smaller solid content.
Case Discussion
Aspergillomas occur in patients with normal immunity but structurally abnormal lungs, with pre-existing cavities.
An asymptomatic aspergilloma does not necessarily require treatment, and the cavity is essentially isolated from any systemic administration of antifungals.
This is a presumptive diagnosis based on the radiological findings and clinical information provided.