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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Aspergilloma. A nearly-round fungus ball (white arrow) has formed in a prior tuberculous cavity (yellow arrows), The patient is supine so the aspergilloma has moved to the dependent portion of the cavity in which it formed.

Aspergilloma. There is a thin-walled upper lobe cavity (white arrows) presumably from old TB, with a fungus ball in the dependent portion (black arrow).

Aspergilloma. There is a thin-walled upper lobe cavity (white arrows) presumably from old TB, with a fungus ball in the dependent portion (red arrow).

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