Skip to main content

Advertisement

SpringerLink
Log in

Pulmonary Diseases with Imaging Findings Mimicking Aspergilloma

  • Published:
Lung Aims and scope Submit manuscript

Abstract

Patients with preexisting lung cavities are at risk of developing intracavitary fungal colonization. Because Aspergillus spp. are the most commonly implicated fungi, these fungal masses are called aspergillomas. Their characteristic “ball-in-hole” appearance, however, may be found in a variety of other conditions that can produce radiologic findings mimicking aspergilloma. In this paper, we review the main diseases that may mimic the radiographic findings of aspergilloma, with brief descriptions of clinical, radiologic, and histopathologic findings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10

Similar content being viewed by others

References

  1. Zmieli OS, Soubani AO (2007) Pulmonary aspergillosis: a clinical update. Q J Med 100:317–334

    Article  Google Scholar 

  2. Soubani AO, Chandrasekar PH (2002) The clinical spectrum of pulmonary aspergillosis. Chest 121:1988–1999

    Article  PubMed  Google Scholar 

  3. Aquino SL, Kee ST, Warnock ML, Gamsu G (1994) Pulmonary aspergillosis: imaging findings with pathologic correlation. Am J Roentgenol 163:811–815

    Article  CAS  Google Scholar 

  4. Thompson BH, Stanford W, Galvin JR, Kurihara Y (1995) Varied radiologic appearances of pulmonary aspergillosis. Radiographics 15:1273–1284

    Article  CAS  PubMed  Google Scholar 

  5. Anstead GM, Graybill JR (2006) Coccidioidomycosis. Infect Dis Clin North Am 20(621):643

    Google Scholar 

  6. Osaki T, Morishita H, Maeda H et al (2005) Pulmonary coccidioidomycosis that formed a fungus ball with 8-years duration. Intern Med 44(2):141–144

    Article  PubMed  Google Scholar 

  7. Winn RE, Johnson R, Galgiani JN, Butler C, Pluss J (1994) Cavitary coccidioidomycosis with fungus ball formation. Diagnosis by fiberoptic bronchoscopy with coexistence of hyphae and spherules. Chest 105(2):412–416

    Article  CAS  PubMed  Google Scholar 

  8. Tonelli AR, Khalife WT, Cao M, Young VB (2008) Spherules, hyphae, and air-crescent sign. Am J Med Sci 335(6):504–506

    Article  PubMed  Google Scholar 

  9. Smego RA, Foglia G (1998) Actinomycosis. Clin Infect Dis 26:1255–1263

    Article  PubMed  Google Scholar 

  10. Severo LC, Kaemmerer A, Camargo JJ, Porto NS (1989) Actinomycotic intracavitary lung colonization. Mycopathologia 108:1–4

    Article  CAS  PubMed  Google Scholar 

  11. Coodley EL, Yoshinaka R (1994) Pleural effusion as the major manifestation of actinomycosis. Chest 106(5):1615–1617

    Article  CAS  PubMed  Google Scholar 

  12. Hsieh MJ, Shieh WB, Chen KS, Yu TJ, Kuo HP, Tsai YH (1996) Pulmonary actinomycosis appearing as a “ball-in-hole” on chest radiography and bronchoscopy. Thorax 51(2):221–222

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Sarodia BD, Farver C, Erzurum S, Maurer JR (1999) A young man with two large lung masses. Chest 116(3):814–818

    Article  CAS  PubMed  Google Scholar 

  14. Wilson JW (2012) Nocardiosis: updates and clinical overview. Mayo Clin Proc 87(4):403–407

    Article  PubMed Central  PubMed  Google Scholar 

  15. Kanne JP, Yandow DR, Mohammed TL, Meyer CA (2011) CT findings of pulmonary nocardiosis. Am J Roentgenol 197(2):266–272

    Article  Google Scholar 

  16. Tilak R, Agarwal D, Lahiri T, Tilak V (2008) Pulmonary nocardiosis presenting as fungal ball-a rare entity. J Infect Dev Ctries 2(2):143–145

    Article  PubMed  Google Scholar 

  17. Baldi BG, Santana AN, Takagaki TY (2006) Pulmonary and cutaneous nocardiosis in a patient treated with corticosteroids. J Bras Pneumol 32(6):592–595

    Article  PubMed  Google Scholar 

  18. Cartledge J, Freedman A (2011) Candidiasis. HIV Med 12:70–74

    Article  Google Scholar 

  19. Abel AT, Parwer S, Sanyal SC (1998) Pulmonary mycetoma probably due to Candida albicans with complete resolution. Respir Med 92(8):1079–1080

    Article  CAS  PubMed  Google Scholar 

  20. Bachh AA, Haq I, Gupta R, Varudkar H, Ram MB (2008) Pulmonary candidiasis presenting as mycetoma. Lung India 25(4):165–167

    Article  PubMed Central  PubMed  Google Scholar 

  21. Burril J, Williams CJ, Bain G, Conder G, Hine AL, Misra RR (2007) Tuberculosis: a radiologic review. Radiographics 27(5):1255–1273

    Article  Google Scholar 

  22. Kim HY, Song KS, Goo JM, Lee JS, Lee KS, Lim TH (2001) Thoracic sequelae and complications of tuberculosis. Radiographics 21:839–860

    Article  CAS  PubMed  Google Scholar 

  23. Sanyika C, Corr P, Royston D, Blyth DF (1999) Pulmonary angiography and embolization for severe hemoptysis due to cavitary pulmonary tuberculosis. Cardiovasc Intervent Radiol 22:457–460

    Article  CAS  PubMed  Google Scholar 

  24. Patel JD (2005) Lung cancer in women. J Clin Oncol 23(14):3212–3218

    Article  CAS  PubMed  Google Scholar 

  25. Parl CM, Goo JM, Lee HJ, Lee CH, Chun EJ, Im JG (2007) Nodular ground-glass opacity at thin section CT: histologic correlation and evaluation of change at follow-up. Radiographics 27(2):391–408

    Article  Google Scholar 

  26. Wang L, Chu H, Chen Y, Perng R (2007) Adenocarcinoma of the lung presenting as a mycetoma with an air crescent sign. Chest 131(4):1239–1242

    Article  PubMed  Google Scholar 

  27. Smahi M, Serraj M, Ouadnouni Y, Chbani L, Znati K, Amarti A (2011) Aspergilloma in combination with adenocarcinoma of the lung. World J Surg Oncol 27(9):27

    Article  Google Scholar 

  28. Torpoco I, Yousuiddin M, Pate JW (1976) Aspergilloma within a cavitatie. Chest 3:561–562

    Article  Google Scholar 

  29. Nilsson J, Restrepo CS, Jagirdar J (2013) Two cases of endobronchial carcinoid masked by superimposed aspergillosis: a review of the literature of primary lung cancers associated with Aspergillus. Ann Diagn Pathol 17:131–136

    Article  PubMed  Google Scholar 

  30. Severo LC, Oliveira FM, Irion K (2004) Respiratory tract intracavitary colonization due to Scedosporium apiospermum: report of four cases. Rev Inst Med Trop Sao Paulo 46(1):43–46

    Article  PubMed  Google Scholar 

  31. Kim M, Ahn MH, Kang JS, Lee H, Joo SI, Park SS, Kim EC (2009) Pulmonary fungal ball of Pseudallescheria boydii identified by LSU rDNA D2 region sequencing. Korean J Clin Microbiol 12(2):87–91

    Article  Google Scholar 

  32. Gilgado F, Cano J, Gené J, Guarro J (2005) Molecular phylogeny of the Pseudallescheria boydii species complex: proposal of two new species. J Clin Microbiol 43(10):4930–4942

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  33. Al Refaï M, Duhamel C, Le Rochais JP, Icard P (2002) Lung scedosporiosis: a differential diagnosis of aspergillosis. Eur J Cardiothorac Surg 21(5):938–939

    Article  PubMed  Google Scholar 

  34. Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa CS (2000) Hydatid disease: radiologic and pathologic features and complications. Radiographics 20(3):795–817

    Article  CAS  PubMed  Google Scholar 

  35. Polat P, Kantarci M, Alper F, Suma S, Koruyucu MB, Okur A (2003) Hydatid disease from head to toe. Radiographics 23(2):475–494

    Article  PubMed  Google Scholar 

  36. Manzoor MU, Faruqui ZS, Ahmed Q, Uddin N, Khan A (2008) Aspergilloma complicating newly diagnosed pulmonary echinococcal (hydatid) cyst: a rare occurrence. Br J Radiol 81(972):e279–e281

    Article  CAS  PubMed  Google Scholar 

  37. Algın O, Gökalp G, Topal U (2011) Signs in chest imaging. Diagn Interv Radiol 17(1):18–29

    PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Medical Imaging Research Lab - Irmandade Santa Casa de Misericórdia de Porto Alegre, Federal University of Health Sciences of Porto Alegre, Professor Annes Dias Street, 295, Porto Alegre, RS, 90560-005, Brazil

    Fernando Ferreira Gazzoni

  2. Mycology Lab - Irmandade Santa Casa de Misericórdia de Porto Alegre, Federal University of Rio Grande do Sul, Professor Annes Dias Street, 285, Porto Alegre, RS, 90020-090, Brazil

    Luiz Carlos Severo & Flavio de Mattos Oliveira

  3. Radiology Department, Federal University of Rio de Janeiro, Pedro Calmon Street, No. 550 - Cidade Universitária, Rio de Janeiro, RJ, 21941-901, Brazil

    Edson Marchiori

  4. Department of Imaging-Hospital AC Camargo, Antonio Prudente, 211, São Paulo, SP, 01509-900, Brazil

    Marcos Duarte Guimarães

  5. Department of Radiology, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool, L14 3PE, UK

    Klaus L. Irion

  6. Irmandade Santa Casa de Misericórdia de Porto Alegre, Professor Annes Dias Street, 295, Porto Alegre, RS, 90020-090, Brazil

    José Jesus Camargo & José Carlos Felicetti

  7. Medical Imaging Research Lab - Irmandade Santa Casa de Misericórdia de Porto Alegre, Federal University of Health Sciences of Porto Alegre, Professor Annes Dias Street, 295, Porto Alegre, RS, 90020-090, Brazil

    Tiago Severo Garcia & Bruno Hochhegger

Authors
  1. Fernando Ferreira Gazzoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Luiz Carlos Severo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Edson Marchiori
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marcos Duarte Guimarães
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tiago Severo Garcia
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Klaus L. Irion
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. José Jesus Camargo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. José Carlos Felicetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Flavio de Mattos Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Bruno Hochhegger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fernando Ferreira Gazzoni.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gazzoni, F.F., Severo, L.C., Marchiori, E. et al. Pulmonary Diseases with Imaging Findings Mimicking Aspergilloma. Lung 192, 347–357 (2014). https://doi.org/10.1007/s00408-014-9568-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00408-014-9568-7

Keywords

Search

Navigation