• Journal of Chest Surgery
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• v.51 no.4
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• pp.273-276
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• 2018

We report the rare case of a 58-year-old woman who was diagnosed with fungal empyema thoracis combined with osteoradionecrosis. After 32 months of home care followed by open window thoracostomy, thoracoplasty with serratus anterior muscle transposition and a latissimus dorsi myocutaneous flap was performed successfully. Although thoracoplasty is now rarely indicated, it is still the treatment of choice for the complete obliteration of thoracic spaces.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1292-1298
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• 1992

This investigation is designed to illustrate the clinical features '||'&'||' preoperative diagnosis, surgical role in the management of pulmonary aspergilloma, '||'&'||' compare with the previous study. We reviewed 42 cases of surgically treated pulmonary aspergillosis from Jan. 1984 to July 1992. The peak age incidence laid in the 2nd '||'&'||' 3rd decade of 25 cases[59.5%]. The 41 cases[97.6%] had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The most common complaint was hemoptysis in 28 cases[66.7%]. The 21 cases showed so called "Air-meniscus sign" on the preoperative chest X-ray. As a preoperative diagnostic modality, the positivity was 30.0%, 57.8%, 88.5% on the fungus culture of sputum for Aspergillus, Chest CT, serum immunodiffusion test for A. fumigatus, respectively. The 37 cases[88.1%] can be diagnosed as pulmonary aspergillosis pre-operatively by any diagnostic method. The anatomical location of aspergilloma was mainly upper lobe in 17 cases[40.5%] '||'&'||' the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 18 cases[41.0%] were combined with tuberculosis '||'&'||' 15 cases[34.1%] were not combined with any other disease[Pr imary Aspergillosis]. The 6 cases showed postoperative empyema including 4 cases of bronchopleural fistula, 3 cases showed postoperative bleeding. One case was died postoperatively due to respiratory failure. In conclusion, when the patient who has longstanding history fo pulmonary tuberculosis '||'&'||' hemoptysis, must be suspected fungal super infection. The resectional surgery is the treatment of choice for symptomatic localized disease. And compare with the previous study, preop. chest CT '||'&'||' immunodiffusion test were more commonly available '||'&'||' showed high positivity.