Intracavitary Fungus Ball— Pulmonary Aspergillosis

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Abstract
A 60-year-old man, who had been successfully treated for tuberculosis in the past, was hospitalized with complaints of hemoptysis and asthenia. There was no longer any clinical or laboratory evidence of active tuberculosis. Roentgenograms of his chest showed an expanded, thinwalled cavity containing a mobile, plastic, spherical mass. Right upper lobectomy was performed, and the specimen removed was found to contain a cavity 8 cm. in diameter, within which was a greyish-brown mass. Microscopic examination showed this to consist of a meshwork of fungal mycelia. The fungus was identified asAspergillusflavus oryzae. Diagnosis was made difficult by the history of tuberculosis and the presence of sickle cell anemia, but the appearance of the mycetoma under x-ray examination was characteristic.

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