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Aspergilloma

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

Patient with history of tuberculosis infection a long time ago. Former smoker.

Patient Data

Age: 65 years
Gender: Male

CT Chest

ct

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.

One year ago

ct

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.

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