Images in Cardiothoracic Medicine and Surgery

Complex bilateral upper lobe aspergilloma

Asian Cardiovascular & Thoracic Annals 2014, Vol. 22(5) 631 ß The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492313483293 aan.sagepub.com

Rajashekara Reddy, Pavan Kumar and Subbaramiah Sanjay

Figure 3. Postoperative chest radiograph showing expanded lungs. Figure 1. Computed tomography in scout view showing both upper lobes were destroyed with a mass.

A 39-year-old woman, who had been treated for pulmonary Koch’s 15 years earlier, presented with hemoptysis of 18 months duration. Computed tomography in scout view showed bilateral upper lobe masses (Figure 1), which were in fact fibrosis and cavitations, with a mass surrounded by air (crescent sign), typical of aspergilloma, seen on a chest computed tomography scan (Figure 2). She had taken fluconazole for 6 months without any relief before coming for surgery. She underwent a median sternotomy and bilateral upper lobectomies with good postoperative recovery (Figure 3). Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Figure 2. Chest computed tomography scan showing the bilateral upper lobes destroyed and bronchiectatic, filled with a mass surrounded by air (crescent sign), suggestive of aspergilloma.

Conflict of interest statement None declared.

Sagar Hospital, Bangalore, India Corresponding author: Rajashekara Reddy, FRCS, Sagar Hospital, 44/54, 30th Cross, Jayanagara, Bangalore, India. Email: [email protected]

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Complex bilateral upper lobe aspergilloma.

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