기관지내 아스페르길루스종 1예

A Case of Endobronchial Aspergilloma

  • 김순종 (건국대학교 의과대학 내과학교실) ;
  • 이응준 (건국대학교 의과대학 내과학교실) ;
  • 이태훈 (건국대학교 의과대학 내과학교실) ;
  • 유광하 (건국대학교 의과대학 내과학교실) ;
  • 이계영 (건국대학교 의과대학 내과학교실)
  • Kim, Sun Jong (Department of Internal Medicine, Konkuk University Hospital School of Medicine, Konkuk University) ;
  • Lee, Eung Jun (Department of Internal Medicine, Konkuk University Hospital School of Medicine, Konkuk University) ;
  • Lee, Tae Hoon (Department of Internal Medicine, Konkuk University Hospital School of Medicine, Konkuk University) ;
  • Yoo, Kwang Ha (Department of Internal Medicine, Konkuk University Hospital School of Medicine, Konkuk University) ;
  • Lee, Kye Young (Department of Internal Medicine, Konkuk University Hospital School of Medicine, Konkuk University)
  • 투고 : 2006.04.18
  • 심사 : 2006.06.20
  • 발행 : 2006.07.30

초록

Pulmonary aspergillosis presents as the following three different types depending on the immune status of the host: invasive aspergillosis, allergic bronchopulmonary aspergillosis (ABPA), and aspergilloma. Aspergilloma develops as a result of an aspergillus growth inside a pre-existing lung cavity. However, endobronchial aspergilloma without a lung parenchymal lesion is quite rare. We encountered a case of endobronchial aspergilloma that developed in a healthy 75 year-old woman that led to necrotizing pneumonia of the right lower lobe. The chief complaints were fever, cough and yellowish sputum. The chest film revealed haziness with cavity-like shadows on the right lower lobe, and the chest CT scan showed endobronchial calcified density in the basal bronchus of the right lower lobe with peribronchial lymph node enlargement. Bronchoscopy revealed an obstruction of the basal orifice of the right lower lobe by blackish stone-like material, and the aspergilloma was confirmed by the bronchoscopic biopsy. The pneumonia improved after bronchoscopic removal of this lesion. We report this case along with a review of the relevant literature.

키워드

참고문헌

  1. Soubani AO, Chandrasekar PH. The clinical spectrum of pulmonary aspergillosis. Chest 2002;121:1988-99 https://doi.org/10.1378/chest.121.6.1988
  2. Greene R. The pulmonary aspergilloses: three distinct entities or a spectrum of disease. Radiology 1981; 140:527-30 https://doi.org/10.1148/radiology.140.2.7255737
  3. Kim JS, Rhee Y, Kang SM, Ko WK, Kim YS, Lee JG, et al. A case of endobronchial aspergilloma. Yonsei Med J 2000;41:422-5 https://doi.org/10.3349/ymj.2000.41.3.422
  4. Kim TH, Yong BJ, Kim YK, Lee YM, Kim KU, Uh ST, et al. A case of endobronchial aspergilloma with massive hemoptysis. Tuberc Respir Dis 2004;57: 589-93 https://doi.org/10.4046/trd.2004.57.6.589
  5. Eom WY, Kim NI, Kim SW, Lee BH, Kim SH, Ahn YS, et al. A case of endobronchial aspergilloma in patient with collapse of right middle lobe.Korean J Med 2006;70:221-5
  6. Rinaldi MG. Invasive aspergillosis. Rev Infect Dis 1983;5:1061-77 https://doi.org/10.1093/clinids/5.6.1061
  7. Hinson KF, Moon AJ, Plummer NS. Broncho-pulmonary aspergillosis: a review and a report of eight new cases. Thorax 1952;7:317-33 https://doi.org/10.1136/thx.7.4.317
  8. Gefter WB, Weingrad TR, Epstein DM, Ochs RH, Miller WT. 'Semi-invasive'pulmonary aspergillosis: a new look at the spectrum of aspergillus infections of the lung. Radiology 1981;140:313-21 https://doi.org/10.1148/radiology.140.2.7255704
  9. Franquet T, Muller NL, Gimenez A, Guembe P, de la Torre J, Bague S. Spectrum of pulmonary aspergillosis: histologic, clinical, and radiologic findings. Radiographics 2001;21:825-37 https://doi.org/10.1148/radiographics.21.4.g01jl03825
  10. Quoix E, Gasser B, Apprill M, Gourdon C, Pauli G, Roegel E. Endobronchial aspergillosis associated with a carcinoid tumor. Rev Mal Respir 1990;7:609-12
  11. le Rochais JP, Icard P, Simon T, Poirier P, Evrard C. Bronchial stump aspergillosis. Ann Thorac Surg 2000;70:302-4 https://doi.org/10.1016/S0003-4975(00)01392-8
  12. Kwon MY, Oh YJ, Ryu JS, Kwak SM, Lee HL, Cho CH, et al. A case of broncholithiasis caused by aspergillus. Tuberc Respir Dis 1999;46:136-41 https://doi.org/10.4046/trd.1999.46.1.136