A radioclinical observation of pulmonalry aspergillosis

Pulmonary aspergillosis can be hardly recognized as such roentgenologically; the smooth dense lesions, oftenwith cavities, are indistinguishable from Tuberculosis and other disease. Sine tuberculosis is a common pulmonarydisease in this country. Aspergillosis is easily misdiagnosed as tuberculosis and a acute form of aspergillosis ismisinterpretated as pneumonia, because of their similarities in roentgenographic findings. Dense spherical massesof fungus growth, called mycetomas or Aspergillomas and better known as fungus balls, are sometimes found inassociation with destructive pulmonary disease, including carcinoma and bronchiectasis. Such a mass can beconfused with tumor but may be indentified if it is lying in a cavity and mantle of air is seen between the massand the cavity wall. Tomograms will sometimes show a characteristic air cap. In sputum culture there lies atroublesome problem because of a ubiquity of Aspergillus. And there is no reliable skin test or serologic testAspergillosis. The 18 cases of Aspergillosis, proven by surgery, histopathology or/with sputum culture under astrict procedure, were encountered at National Medical Center in the long period of time from april 1962 oNovember 1976, and those cases are analyzed radiologically and clinically. The following results were obtained :1. The 10 cases of pulonary aspergillosis were found in male and the 8 cases in female. Their age range was widefrom 20 to 60 years. And the 12 cases (67%) were in the age of 20 to 40 years. 2. The most frequent site of thelesion was in the right upper lobe (9 cases) 3. There were 12 (67%) cases of primary aspergillosis and 6 cases of2ndary one. 4. The characteristic fungus ball with the air cap within the cavity was demonstrated in 8 cases inthe tomographic study. 5. The main clinical symptoms were composed of chronic coughing, purulent sputum andhemoptysis and the 10 cases of these patients were misdiagnosed to have tuberculosis. And the 5 cases hadantituberculosis therapy for more than 5 years. 6. The pulmonary tuberculosis and pleurisy were the most frequentassociated disease in pulmonary Aspergillosis.