Endobronchial aspergilloma: A case report and literature review

Back ground: To investigate the clinical and radiological characteristics as well as the bronchoscopic appearance in patients with endobronchial aspergilloma (EBA). Methods: We analyzed the clinical and radiological characteristics as well as the bronchoscopic appearance in 17 patients with EBA. Results: 13 men and 4 women were included, with a median age of 59. The main symptom was hemoptysis (9/17, 53%). Chest CT showed a significantly higher incidence of aspergillosis lesion in the left than the right lung (13/17, 76.5% vs. 4/17, 23.5%). CT manifestation included space occupying disease in 10 patients (58.8%), aspergilloma in 3 patients (17.6%), pneumonic consolidation in 2 patients (11.8%) and GGO (ground glass opacity) in 1 patient (5.9%). Bronchoscopy examination found masses in all 17 patients9 bronchial lumen and 15 patients had endobronchial obstruction by necrotic material. Our case demonstrated the value of combining bronchosopic intervention with voriconazole. Conclusions: EBA lesions were more found in the left lung rather than the right. EBA often occurs in people with underlying lung diseases which cause lumen structural change or bronchial obstruction. The possibility of the co-exististing tumor should be considered in EBA patients. Bronchoscopic intervention and anti-fungal therapy may have an advantage in the effective treatment of EBA patients.