Presentation
Elderly patient with past history of TB. Worsening respiratory symptoms and hemoptysis.
Patient Data
Bilateral upper lobe cavities. The left upper lobe cavity contains a soft tissue mass with a crescent of surrouning air.
Scarring, pleural thickening and bronchiectasis in both lungs.
No significant mediastinal abnormality.
Left upper lobe cavity containing an asperilloma (red circle).
Case Discussion
An aspergilloma is one form of pulmonary aspergillosis. This is a 'ball' of fungus which forms in a pre-existing cavity in the lungs.
The appearances are term the Monod sign which simply describes the air that surrounds a mycetoma (most commonly an aspergilloma) in a pre existing pulmonary cavity. It is often used interchangably with the 'air crescent sign'.