Aspergilloma

• Caused by Aspergillus fumigatus-soil fungus 

• Non-invasive Aspergillosis 

• Colonization of pre-existing cavity 

• Most frequently TB cavity or Sarcoid
  

• Also can occur with cavitary ca, and bronchiectasis 

• Most common symptom is hemoptysis 

• Histologically, these are intertwined hyphae of the aspergillus
  forming a mycetoma 

• Findings: 

• Solid, round mass in thin-walled cavity

• Usually in upper lobes

• > Moves with changes in positioning

• Crescent-shaped airspace separates the fungus ball from the wall of cavity

• Fungus ball may calcify

Aspergillomas, both upper lobes. White arrows point to two masses contained within cavities in both upper lobes, the one on the right larger than the left. The masses represent aspergillomas in cavities of a patient with a prior history of sarcoidosis.
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