A Case of Endobronchial Aspergilloma Presented by Solitary Pulmonary Nodule

고립성 폐 결절 형태로 나타난 기관지 내 국균종 1예

  • Lee Ki-Man (Department of Internal Medicine, College of Medicine, Chungbuk National University) ;
  • Kim Sung-Jin (Department of Radiology, College of Medicine and Research Institute, Chungbuk National University) ;
  • Hong Jong-Myeon (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chungbuk National University)
  • 이기만 (충북대학교 의과대학 내과학교실) ;
  • 김성진 (충북대학교 의과대학 영상의학과교실 의학연구소) ;
  • 홍종면 (충북대학교 의과대학 흉부외과학교실)
  • Published : 2006.08.01

Abstract

A 53 year-old woman visited to our hospital due to increased hemoptysis for 4 days. The chest X-ray showed solitary pulmonary nodule on right upper lobe and computed tomography of chest demonstrated mass on posterior segmental bronchus of right upper lobe. Bronchoscopic examination revealed that this segmental bronchus was completely obstructed by a yellow and brownish mud like mass, which was identified as an aspergilloma by pathologic examination. Patient had undergone bilobectomy because of persistent hemoptysis. Tracheobronchial apergillosis in an immunocompetent person is very rare disease. then, we report this case with review of the Korean literature.

53세 여자가 내원 4일 전부터 심해지는 객혈을 주소로 내원하였다. 흉부 X-선상 우상엽에 고립성 폐결절이 보였고, 흉부 컴퓨터 단층 촬영상 우상엽 후분절 기관지를 막고 있는 결절을 보였다. 기관지 내시경적 검사로 우상엽 후분절 기관지를 완전히 막고 있는 부스러지기 쉬운 황색과 갈색의 진흙 같은 덩어리가 보였고 생검 병리학적 검사로 국균종으로 진단되었다. 환자는 지속되는 객혈로 인해 우상엽 및 우중엽 절제술을 시행하였다. 기관-기관지 국균증은 면역기능이 정상인의 경우에는 아주 드물게 나타나는 형태의 국균증이기에 우리나라 문헌에서 보고된 기관지 내 국균증의 고찰과 함께 비교하여 본 증례를 보고하는 바이다.

Keywords

References

  1. Clarke A, Skelton J, Fraser RS. Fungal tracheobronchitis report of 9 cases and review of the literature. Medicine 1991; 70:1-4 https://doi.org/10.1097/00005792-199101000-00001
  2. Kwon MY, Oh YJ, Ryu JS, 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
  3. Kim JS, Rhee YM, Kang SM, 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. Chung HY, Kim HJ, Kim SH, et al. A case of aspergillus tracheobronchitis in non-immunocompromised patient. Tuberc Respir Dis 2000;49:508-13 https://doi.org/10.4046/trd.2000.49.4.508
  5. Kim TH, Yong BJ, Kim YK, 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
  6. Choi CK, Tyu JK, Bae JS, et al. A case of broncholithiasis caused by aspergillus with broncho-obstructive pneumonia and massive hemoptysis. Tuberc Respir Dis 2005;59:104-8 https://doi.org/10.4046/trd.2005.59.1.104
  7. Park BJ, Kim YK, Kim HS, et al. A case of endobronchial aspergillosis completely obstructing lobar bronchus. Tuberc Respir Dis 2005;59:311-4 https://doi.org/10.4046/trd.2005.59.3.311
  8. Eom WY, Kim NI, Kim SW, et al. A case of endobronchial aspergilloma in patient with collapse of right middle lobe. Korean J Med 2006;70:221-5