Pulmonary aspergilloma on transthoracic ultrasound

Abstract

Purpose: Pulmonary aspergilloma affects immunocompromised patients but is also a recurrent condition in patients previously treated for pulmonary tuberculosis.

Methods and results: We report the case of a 45-year-old patient with a history of cured pulmonary tuberculosis 15 years earlier in whom we visualized pulmonary aspergilloma by transthoracic lung sonography. Sonography of pulmonary aspergilloma demonstrated an oval cavity with hypoechoic contents and an irregular border, measuring a diameter of 4.7 cm; inside the lesion, a roundish structure with an anechoic rim was discernable.

Conclusions: The sonographic findings corresponded to chest X-ray and computed tomography imaging in this patient and to previously reported sonographic characteristics of mycotic abscesses in other organs. Lung ultrasound may be a tool to identify pulmonary aspergilloma, especially as a point-of-care imaging tool and where other imaging modalities are inaccessible.

Keywords: Aspergilloma; Lung; Tuberculosis; Ultrasound.

Fig. 1

a Sonographic image with phased array probe shows oval cavity with irregular border and hypoechoic contents, the arrow marks a roundish structure with an anechoic rim. b Roundish structure, the arrowheads mark the anechoic rim

Fig. 2

Posterior-anterior radiograph of the chest (a) and coronal CT reformation (b) shows fibrocavitary lesions in bilateral upper lobes. Left upper lobe cavity shows dependant intracavitary opacity with air crescent (arrow) in keeping with aspergilloma