Aspergillus-related lung mass masquerading as a lung tumour. Issue 7 (14th July 2020)

• Record Type: Journal Article
• Authors: Mohamed, Saifullah; Patel, Akshay J; Darr, A; Jawad, Faisal; Steyn, Richard
• Is Part Of: Journal of surgical case reports. Volume 2020:Issue 7(2020)
• Publication Date: 2020-07-14
• Subjects: Aspergillosis -- Lung cancer -- Malignancy -- Positron emission tomography—CT (PET-CT) -- Bronchoscopy; Surgery -- Periodicals; Surgery -- Case studies -- Periodicals; 617.005
• DOI: 10.1093/jscr/rjaa169
• Languages: English
• ISSNs: 2042-8812

Abstract

ABSTRACT: Aspergillus is a common environmental pathogen. However, clinically significant disease only occurs in a small proportion of patients. Although rare in its occurrence, it remains a considerable cause of morbidity and mortality in certain cohorts of patients. We describe a rare case of Aspergillus disease masquerading as a primary lung malignancy. Computer tomography pulmonary angiogram scan demonstrated a right upper lobe 8 x 6.5 cm soft-tissue lesion. Positron emission tomography CT demonstrated this lesion to be intensely fluorodeoxyglucose avid. Initial bronchoscopy demonstrated occluded subsegmental right upper lobe bronchus with white friable material. Follow-up bronchoscopy demonstrated evidence of a previous inflammatory process with cavitation and destruction of sub-lobar bronchial tree. Serial chest radiographs demonstrated almost complete resolution of the right upper lobe mass. Thus, this presentation of an Aspergillus -related lung mass masquerading as a primary lung malignancy provided several important learning points pertaining to diagnosis and ensuing management.