• Journal of Chest Surgery
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• 제24권8호
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• pp.814-818
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• 1991

Infection with the ubiquitous fungus Aspergillus is uncommon. This organism has a low pathogenicity for man. In most patients, pulmonary Aspergilloma is the most common form of disease, and Aspergillus fumigatus is the common species. The natural history of the pulmonary aspergilloma is variable. This report reviews the feature of growing pulmonary aspergilloma for 10 years[from diameter 3cm to diameter 9cm]. This 44-year-old male patient suffered from recurrent hemoptysis for 10 years. This patient was taken removal of aspergilloma and cavernoplasty of left upper lobe. Post-operation course was uneventful.

• Journal of Chest Surgery
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• 제28권7호
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• pp.689-692
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• 1995

Pulmonary aspergilloma is a rare disease, most commonly presenting as secondary invasion of preexisting cavitary disease. Tuberculosis and bronchieetasis were the commonest pre-existing diseases. Between 1990 and 1994, 11 patients[7 male and 4 female underwent thoracotomy for treatment of pulmonary aspergilloma. The mean age was 45.7 years. The most common indication for operation was hemoptysis. Lobectomy was the m&t frequent operation. Major complication occurred in a patient with bronchopleural fistula and treated with open drainage. There was no operative death. It is concluded that elective pulmonary resection is recommended for all patients with aspergilloma who do not constitute prohibitive operative risks.

• Journal of Chest Surgery
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• 제26권10호
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• pp.775-780
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• 1993

Pulmonary aspergilloma resulting from colonization of Aspergillus fumigatus is potentially life-threatening disease due to massive hemoptysis. Between August 1990 and November 1993, twelve patients were operated for the treatment of pulmonary aspergilloma. The mean age was 38.8 years. All patients had underlying cavitary lung disease, and the tuberculosis is the most common cause. Ten patients have experienced hemoptysis, but the clinical presentation of hemoptysis at the time of operation was mostly intermittent and scanty. Operative procedures were segmentectomy in 1 patient, lobectomy in 8, pneumonectomy in 2, and pleuropneumonectomy in 1. There were three complications, bronchopleural fistula in one patient and prolonged air leak in 2. There was no postoperative death. Conclusively, our results suggest that established aspergilloma associated with tuberculosis or other cavitary lesions should undergo early elective pulmonary resection, even though it has only minimal hemoptysis.

• Journal of Chest Surgery
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• 제33권3호
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• pp.245-251
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• 2000

Backround: Pulmonary aspergilloma is a potential life-threatening disease resulting from massive hemoptysis. Pulmonary aspergilloma has been treated surgically for many years, however, it has also had higher risk of mortality and complication rate. The purpose of this study is to analyze the operative methods and the types of complications. Material and Method: Sixty patients who underwent surgical resection for pulmonary their medical reconrds. Result: The mean age was 46.3$\pm$13.4 years(range 20 to 76 years). The most common clinical presentation was hemoptysis which occurred in 48 patients(80%). Pulmonary tuberculosis was the most common pre-existing disease, occurri9ng in 28 patients(46.7%). The other associated lung diseases were bronchiectasis(n=11), silicosis(n=2), and chronic pnumonia(n=1). Operative proceudres wer lobectomy in 35 patients, pneumonectomy in 6, segmentectomy in 5, lobectomy and thoracoplasty in 3, segmentectomy and thoracopasty in 1, and cavernostomy in 10. The operative mortality was 6%(n=3) in lung resection patients but 0% in cavernostomy patients. The most common complications were prolonged air leakage, wound infection and postoperative bleeding. Conclusion: In most cases of pulmonary aspergilloma surgical resectin remains the only effective therapy. However, cavernostomy may be more effective for pulmonary aspergilloma patients with decreased pulmonary functions and for patients with high risk for lung resection.

• Journal of Chest Surgery
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• 제24권10호
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• pp.1011-1018
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• 1991

From September, 1985 to March, 1991, 33 patients under went thoracotomy for treatment of pulmonary aspergilloma with Pulmonary tuberculosis on the department of Thoracic and Cardiovascular Surgery, National Kongju Hospital. 1. There were 25 male and 8 female patients ranging from 19 to 57 years old [mean age, 36.2 years]. 2. Hemoptysis was the most common symptom [recurrent minor hemoptysis: 24cases, severe hemoptysis [200cc /day]: 4 cases, massive hemoptysis [600/day]: 4 cases]. 3. In the chest X-ray films, intracavitary fungus balls [air meniscus sign] were noted in 20 cases [61%] and upper lobe involvements were 29 cases [88%]. 4. All cases had a history of treatment with antituberculosis drugs under diagnosis of pulmonary tuberculosis for an average of 10 years and 2 months. 5. The most common indication for operation was hemoptysis [32 cases] - hemoptysis with total destroyed lung or lobe: 12cases, hemoptysis with open AFB [t-] cavity: 6cases, recurrent or massive hemoptysis: 14 cases. 6. The operative procedures was as follows - - - lobectomy . 16 cases, pneumonectomy: 8 cases, bilobectomy, segmentectomy, cavernoplasty and lobectomy with segmentectomy: each 2 cases, lobectomy with cavernoplasty: 1 case. 7. 6 complications appeared postoperatively which included empyema with BPF [2 cases], empyema [2 cases] and wound infection [2 cases]. In conclusion, surgical resection is the treatment of choice in the management of pulmonary aspergilloma associated pulmonary tuberculosis.

• Tuberculosis and Respiratory Diseases
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• 제39권2호
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• pp.180-185
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• 1992

The most common symptom associated with an pulmonary aspergilloma is hemoptysis, with estimates of frequency ranging from 50 to 85 percent of patients. Hemoptysis may be infrequent and minimal in amount or it may be severe with a fatal outcome. The major options available for the treatment of pulmonary aspergilloma include sugical resection of the lesion, a number of medical therapies, or simple observation of the patient for a time. Surgery is the treatment of choice but it is not feasible in some patients who have diffuse or advanced pulmonary disease that makes them poor candidates for thoracotomy. As an alternative to it, some categories of therapy including bronchial artery embolization and parenteral or endobronchial administration of antifungal drugs were tried without remarkable success. But percutaneous instillation of intracavitary amphotericin B for symptomatic aspergilloma has been reported with better result. The authors present a case of percutaneous intracavitary instillation of amphotericin B for the treatment of pulmonary aspergilloma and its successful result for the repetitive hemoptysis.

• Tuberculosis and Respiratory Diseases
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• 제41권1호
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• pp.42-46
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• 1994

저자들은 반복적인 객혈이 있는 폐국균종 환자에서 경피적 공동내 Amphotericin B의 주입에 의해 객혈에 대한 효과적인 치료 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제17권3호
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• pp.484-487
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• 1984

A 12-yr-old patient was admitted due to severe hemoptysis and known cyanotic CHD. In chest P-A and echocardiogram, pulmonary aspergilloma in left upper lobe was associated with TOF. The cardiac catheterization couldnt be done because of frequent hypoxic spell and severe hemoptysis. Surgical management was performed. After left posterolateral thoractomy, modified Blalock-Taussig shunt operation and left upper lobe lobectomy were done at same time. Postoperative PaO2 was elevated and hemoptysis was disappeared.

• Journal of Chest Surgery
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• 제26권3호
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• pp.234-235
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• 1993

We have experienced a case of congenital heart disease who developed pulmonaryaspergilloma and then had open heart surgery associated with pulmonary resection. A 53 year old female patient was admitted of fever and chill without cyanosis and hemoptysis. Chest CT showed cavitary lesion with enhanced wall in right midle lung and huge pulmonary artery. Secundum atrial septal defect was identified by echocardiography and catheterization, preoperatively. The patient was identified finally as atrial septal defect associated with pulmonary aspergilloma, in operation and pathology.

• Journal of Yeungnam Medical Science
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• 제10권1호
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• pp.157-165
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• 1993

저자들은 1983년 3월부터 1992년 3월까지 영남대학교 의과대학 부속병원에서 경험한 13례의 aspergilloma환자를 대상으로 임상적 관찰을 하여 다음과 같은 결과를 얻었다. 1) 남녀간 발생빈도는 1 : 1.2로 차이는 없었고 연령은 30세에서 67세로 다양하였다. 2) 임상증상은 대부분 환자에게서 객혈, 기침 및 객담등 호흡기 증상이 있었고 특히 객혈은 10례(77%)에서 관찰되었다. 3) 기존폐질환으로는 폐결핵, 만성폐색성폐질환, 기관지확장증 순이었고 이를 질환이 진단되고 5년에서 10년사이에 가장 많이 발병하였다. 4) 흉부방사선 소견으로는 확정적인 공동내 초승달 증후가 보인 경우가 8례였고 폐결절으로 보인 경우는 5례였다. 병변의 부위는 폐상엽에서 호발하였다. 5) 수술적 제거를 한 경우는 10례로 진단적 목적이 7례, 심한 객혈때문인 경우는 3례였다. 이중 8례는 생존해 있으며 2례에서는 사망하였다. 그리고 특별히 치료를 하지 않은 3례에서는 지속적인 호흡곤란과 객혈을 호소하였다. 이들 소견들은 aspergilloma의 진단과 치료에 도움이 될 것으로 생각되며 이 질환의 예후에 대한 명가에는 앞으로 더 많은 예수와 장기간의 추적조사가 필요하다고 생각된다.