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Ham, Lee, Cho, Jeon, Jeong, Kim, Lee, and Hwang: A Case of Lung Cancer Obscured by Endobronchial Aspergilloma
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2006; 61(2): 157-161.

Published online: 31 August 2006

DOI: https://doi.org/10.4046/trd.2006.61.2.157

A Case of Lung Cancer Obscured by Endobronchial Aspergilloma

Hyun Seok Ham, M.D., Seung Jun Lee, M.D., Yu Ji Cho, M.D., Kyoung Nyeo Jeon, M.D.1, Yi Yeong Jeong, M.D., Ho Cheol Kim, M.D., Jong Deok Lee, M.D., Young Sil Hwang, M.D.

Department of Internal Medicine, College of Medicine, Gyeongsang National University, Jinju, Korea.

1Department of Diagnostic Radiology, College of Medicine, Gyeongsang National University, Jinju, Korea.

Address for correspondence: Ho Cheol Kim, M.D. Department of Internal Medicine, College of Medicine, Gyeongsang National University. 92 Chilam Dong, Jinju, 660-751, Korea. Phone: 055-750-8684, Fax: 055-758-9122, hochkim@gshp.gsnu.ac.kr

Received 18 April 2006       Accepted 23 June 2006

Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

A 70-year-old man was referred to the department of pulmonology due to blood tinged sputum and an abnormal chest X-ray. The chest X-ray and CT scans revealed a lobulated contour mass-like lesion in the left upper lung field. The bronchoscopic examination showed a whitish and polypoid mass occluding the left upper lobe bronchus. A biopsy specimen from the lesion revealed many aspergillus hyphae. Intravenous and oral itraconozole were administered over a 4 weeks period. Several months later, the size of the mass on chest X-ray increased and a percutaneous lung biopsy revealed a sarcomatoid carcinoma. We reported a case of lung cancer that was obscured by an endobronchial aspergilloma with a review of the relevant literature.

Keywords: Endobronchial aspergilloma, Lung cancer

Figures and Tables

Figure 1
Initial chest radiograph showed mild cardiomegaly and barbell shaped mass-like opacity in left upper lung field.
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Figure 2
A CT scan showed multi-lobulated contour and non-enhancing soft tissue mass -like lesion in left upper lobe posterior segment.
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Figure 3
Bronchoscopic examination showed whitish and polypoid mass occluding left upper lobe apicoposterior segment.
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Figure 4
Histologic finding of the mass showed numerous branched, septated aspergillus hyphae with adjacent fibrous exudates in PAS stain(× 100).
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Figure 5
Several months later, the size of mass increased in chest radiograph and CT scan.
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Figure 6
Immunohistochemical staining showed that a pleomorphic tumor with spindle cells, positive for vimentin, are invading into normal large round pale pink muscle fibers(×400)
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