DISCUSSION: In immunocompetent patients, aspergillosis requires structural changes to allow colonization of the bronchial lumen. There are few reports of the fungal growth without preexisting lung cavities or lesions. One such analysis proposed classifying endobronchial aspergillosis without systemic predisposing factors into ABPA, ABPA without asthma, ABPA-seropositive, and endobrochial aspergilloma. The non-invasive, endobronchial type can present as either the sole manifestation or present with other forms of pulmonary aspergillosis. Optimal treatment has not been established as the endobronchial lesion has been thought to represent simple colonization in an immunocompetent host. In pulmonary aspergilloma, surgical resection is favored and while medical therapy usually has no benefit, in an endobronchial lesion, a larger role for medical therapy may be needed, especially, if this is not colonization.