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Bronchoscopic Removal of a Large Intracavitary Pulmonary AspergillomaBronchoscopic Intracavitary Aspergilloma Removal

David R. Stather, MD, FCCP; Alain Tremblay, MDCM, FCCP; Paul MacEachern, MD, FCCP; Alex Chee, MD; Elaine Dumoulin, MDCM; Olga Tourin, MD; Gary A. Gelfand, MD; Christopher H. Mody, MD, FCCP
Author and Funding Information

From the Department of Medicine (Drs Stather, Tremblay, MacEachern, Chee, Tourin, and Mody) and the Department of Surgery (Dr Gelfand), University of Calgary, Calgary, AB; and the Department of Medicine (Dr Dumoulin), University of Sherbrooke, Sherbrooke, QC, Canada.

Correspondence to: David R. Stather, MD, FCCP, Division of Respiratory Medicine, Health Sciences Center, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada; e-mail: davestather@yahoo.ca


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(1):238-241. doi:10.1378/chest.12-0400
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Pulmonary aspergilloma is a chronic fungal infection that has a high mortality when hemoptysis occurs. Surgery is the treatment of choice, but patients often have severe physiologic impairment putting them at risk for significant surgical morbidity and mortality. We present the case of a 63-year-old woman with a large aspergilloma, unfit for surgery due to medical reasons. The aspergilloma was enlarging, with progression of the patient’s symptoms of anorexia, cough, chest discomfort, and hemoptysis. Bronchoscopy revealed an airway leading into a cavity with a large fungal ball. Biopsy confirmed Aspergillus fumigatus. Using flexible and rigid bronchoscopy, the aspergilloma was mechanically removed. Eighteen months later the patient reported no hemoptysis, reduced pain and cough, significant weight gain, and improved appetite, with no recurrence of the aspergilloma on repeat imaging. To our knowledge, this is the first reported case of bronchoscopic removal of a large cavitary aspergilloma. This important new treatment modality provides a viable alternative therapy for this potentially life-threatening problem.

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