Abstract
The clinical, rentgenologic, laboratory findings and treatment of 39 patients with pulmonary aspergillosis admitted to Muramatsuseiranso National Sanatorium have been reviewed.
1) general description
The number of cases per year was generally 2 to 8 during the period from 1957 through 1968.
This figure suggests that pulmonary aspergillosis is rare disease, and does not indicate an annual increase of this disease.
Most of them were found in the course of the treatment of pulmonary tuberculosis for 3 to 10 years. All except one showed an aspergilloma on chest X-ray film. Five cases accompanied with non-tuberculous changes also showed an aspergilloma.
No significant difference between both sexes was observed. The more cases were found rather in higher age.
The basic changes of them were pulmonary tuberculosis or pulmonary cysts or bronchiectasis.
All of the aspergilloma were suprophytic.
2) chest X-ray findings
The key point of the rentgenologic diagnosis is to inspect an open healed tuberculous cavity of the lung and bronchiectasis. The tuberculous changes in the background field were cicatrization or fibrosis lacking in perifocal opacity. In some cases the cavity showed diffuse opacity at the beginning of the disease.
The rentgenograms of some types of aspergilloma were presented.
3) clinical symptoms and the results of laboratory examination
Although hemoptysis was common at the time of the confirmation of an aspergilloma on the chest X-ray film, it was unlikely that the hemoptysis attribute to the development of an aspergilloma. Usually sputum culture for tubercle bacilli were negative at this time. It was noticeable that a typical conidiophore and vesicle with sterigmata was not found in resected fungus balls except one which was obtained from a big well airated cyst. All except one aspergillus cultured from sputum or resected fungus balls could be classified in Aspergillus fumigates group.
4) treatment
Pulmonary resection or cavernostomy were performed for 27 patients out of 29 cases. Eight out of 12 conservatively treated cases died of cardiopulmonary insufficiency caused by their previous pulmonary tuberculosis or other diseases which were not related to the aspergilloma.
