Abstract
Background. Pulmonary aspergillosis shows a variety of clinical states, and there are cases including different types. Here, we report a resected case of pulmonary aspergilloma overlapping with a clinical state suspected to be allergic bronchopulmonary aspergillosis (ABPA), which was preoperatively controlled by steroid therapy. Case. A 73-year-old man with a history of right upper and middle bilobectomy for non-tuberculosis mycobacterium infection about three years ago in another hospital, was diagnosed with a fungal ball in the right apical thoracic cavity about one year before admission to our hospital. He showed left lung infiltration one month prior, and was admitted to our hospital for progression of hypoxia. Because his condition did not improve with antibiotics, we suspected ABPA based on the elevation of Aspergillus-specific IgE. His symptoms remarkably improved after steroid administration. Subsequently, cavernostomy and intrathoracic transplantation of latissimus dorsi myocutaneous flap were performed. After this procedure, the patient showed air leakage from a bronchial fistula, which was successfully treated with bronchoscopic embolization of fibrin glue. Conclusion. Multimodality therapy for pulmonary aspergilloma resulted in a favorable therapeutic outcome.
