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| __NOTOC__
| | #redirect [[Aspergillosis]] |
| {{Aspergilloma}}
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| {{CMG}}
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| == Etiology ==
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| The most common place affected by aspergillomas is the lung. ''[[Aspergillus fumigatus]]'', the most common species, is typically inhaled as small (2 to 3 [[micrometre|micrometer]]) [[spore]]s which do not affect people without underlying lung or [[immunocompromised|immune system]] [[disease]]. However, people who have pre-existing lung problems, especially the cavities typically caused by [[tuberculosis]], are at risk for developing aspergillomas. The fungus settles in a cavity and is able to grow free from interference because the immune system is unable to penetrate into the cavity. As the fungus multiplies, it forms a ball which incorporates dead tissue from the surrounding lung, mucus, and other debris.
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| == Clinical syndrome ==
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| Typically, individuals who are affected by aspergillomas do not have [[symptom]]s related to the infestation. People often co-exist for decades with aspergillomas prior to incidental [[diagnosis]], typically by [[x-ray]] or [[computed tomography]]. However, a small percentage of aspergillomas invade into the wall of the cavity and can result in bleeding. Thus, the most common symptom of aspergillomas is [[cough]]ing up blood ([[hemoptysis]]). Although this can occasionally be life-threatening, the amount of blood produced is usually inconsequential.
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| Aspergillomas can form in other body cavities. Aspergillus can form [[abscess]]es in the brain, usually in people who are immunocompromised. They can also form within the different [[Paranasal sinus|sinuses]] in the face, within the [[kidney]]s and [[urinary system]], the [[ear canal]], and on the [[heart valve]]s.
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| ==Diagnosis==
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| The imaging findings are
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| * Intracavitary mass
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| * Usually in upper lobes
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| * Air may surround aspergilloma (Monod sign). This is not to be confused with the Air crescent sign seen with invasive apergillosis
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| * Moves with changing positions
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| * Adjacent pleural thickening is common
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| <gallery>
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| Image:
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| Mycetoma-001.jpg
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| Image:
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| Mycetoma-002.jpg
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| Image:
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| Mycetoma-003.jpg
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| </gallery>
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| == Treatment ==
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| Most cases of aspergilloma do not require treatment. Treatment of diseases which increase the risk of aspergilloma, such as tuberculosis, may help prevent their formation. In cases complicated by severe hemoptysis, [[surgery]] may be required to remove the aspergilloma and stop the bleeding. There has been interest in treatment with anti-fungal [[medication]]s such as [[itraconazole]], but as of [[2005]], none has been shown to eradicate aspergillomas.
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| == References ==
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| *Soubani AO, Chandrasekar PH. ''The clinical spectrum of pulmonary aspergillosis.'' Chest. 2002 Jun;121(6):1988-99. Review. PMID 12065367
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| [[nl:Aspergilloom]]
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| [[de:Aspergillom]]
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| [[Category:Pulmonology]]
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