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Surgical treatment of pulmonary aspergilloma
Abstract:
Fourteen patients with aspergilloma (fungus ball) were reviewed. Hemoptysis was the major symptom (93%). Chest roentgenograms disclosed a "fungus ball" in every patient, and the mycelia of Aspergillus fumigatus were recovered from all resected specimens. One of three patients treated by pneumonectomy died post-operatively. A lobectomy was performed in ten patients, and segmental resection in one without mortality or significant morbidity. There has been no evidence of recurrence in a follow up of six months to ten years. On the basis of this experience and a review of the literature, excision of a solitary "fungus ball" is recommended when the diagnosis is made. Non-surgical therapy should be reserved for patients whose general medical status or pulmonary reserved prohibit resection.
Insights
Surgical excision of solitary pulmonary aspergilloma (fungus ball) is recommended for most patients. Non-surgical options are reserved for those unable to undergo resection due to medical conditions.
Area of Science:
- Pulmonology
- Mycology
- Thoracic Surgery
Background:
- Pulmonary aspergilloma, or fungus ball, is a serious condition often presenting with hemoptysis.
- Diagnosis relies on imaging and laboratory identification of Aspergillus fumigatus.
Purpose of the Study:
- To evaluate the efficacy and safety of surgical resection for pulmonary aspergilloma.
- To provide treatment recommendations based on clinical experience and literature review.
Main Methods:
- Retrospective review of fourteen patients diagnosed with pulmonary aspergilloma.
- Analysis of symptoms, diagnostic findings, surgical procedures, and patient outcomes.
- Literature review of non-surgical and surgical treatment modalities.
Main Results:
- Hemoptysis was the predominant symptom in 93% of patients.
- Chest roentgenograms confirmed fungus balls in all cases; Aspergillus fumigatus was identified in resected specimens.
- Lobectomy (10 patients) and segmental resection (1 patient) had no mortality or significant morbidity. Pneumonectomy (3 patients) resulted in one post-operative death.
- No recurrence observed during follow-up periods ranging from six months to ten years.
Conclusions:
- Surgical excision of solitary pulmonary aspergilloma is a safe and effective treatment.
- Non-surgical management should be reserved for medically compromised patients.
- Early diagnosis and surgical intervention lead to favorable long-term outcomes.