Aspergilloma ve idiyopatik pulmoner fibrozis: Nadir Birliktelik

Yıl 2021, Cilt: 28 Sayı: 2, 351 - 354, 15.06.2021

Haci Ahmet Bircan Ahmet Akcan

https://doi.org/10.17343/sdutfd.730134

Öz

Pulmoner aspergilloma (miçetoma) genellikle önceki
tüberküloz, fibrotik sarkoidoz veya interstisyel akciğer
hastalıkları dahil fibrokaviter hastalıklar nedeniyle gelişen
kistik ve kaviter lezyonlara kolonize olan Aspergillus
türlerine bağlı gelişen saprofitik bir fungal enfeksiyondur.
İdiyopatik pulmoner fibrozis (İPF), nadir,
kronik ilerleyici fibrotik akciğer hastalığıdır ve olağan
interstisyel pnömoni histolojisi ile karakterizedir. Diyabetik
ve ağır sigara içicisi olan 69 yaşındaki erkek
hasta kuru öksürük, nefes darlığı, ateş ve kilo kaybı
şikayetleri ile kliniğimize başvurdu. Pulmoner aspergilloma
ve İPF birlikteliği tanısı yüksek çözünürlüklü
bilgisayarlı tomografi bulgularına göre kondu. Burada,
İPF zemininde Aspergillus enfeksiyonu gelişmesi ile
ilgili olan bu nadir olguyu literatür eşliğinde sunmak
istedik.

Anahtar Kelimeler

Aspergilloma, Kavite, Fungus topu, İdiyopatik pulmoner fibrozis

Aspergilloma and Idiopathic Pulmonary Fibrosis: A Rare Coexistence

Öz

Pulmonary aspergilloma (mycetoma) usually is a
saprophytic fungal infection due to aspergillus species
which is colonized and grows into pre-existing cystic/
cavitary lesions resulting from pulmonary tuberculosis
or fibrotic sarcoidosis, or other fibro-cavitary diseases
including interstitial lung diseases. Idiopathic pulmonary
fibrosis (IPF) is a rare, chronic, progressive
fibrotic lung disease, characterized by the histological
pattern of usual interstitial pneumonia. Heavy smoker,
diabetic, a 69-year-old male patient was admitted to
our clinic with complaints of dry cough, fever, dyspnea
on exertion and weight loss. The diagnosis was made
as coexisting of pulmonary aspergilloma and IPF according
to findings on HRCT. Hereby, we wanted to
present this rare case regarding of coexisting of the
development of Aspergillus infection and idiopathic
pulmonary fibrosis in the light of the literature.

Anahtar Kelimeler

Aspergilloma, Cavity, Fungus ball, Idiopathic pulmonary fibrosis

Kaynakça

• 1. Kumar N, Mishra M, Singhal A, Kaur J, Tripathi V. Aspergilloma coexisting with idiopathic pulmonary fibrosis: a rare occurrence. J. Postgrad. Med. 2013; 59:145-148.
• 2. Ma JE, Yun EY, Kim YE, Lee GD, Cho YJ, Jeong YY, et al., Endobronchial aspergilloma: report of 10 cases and literature review. Yonsei. Med. J. 2011; 52: 787-792.
• 3. Huang D, Li B, Chu H, Zhang Z, Sun Q, Zhao L, et al., Endobronchial aspergilloma: A case report and literature review. Exp Ther Med. 2017; 14: 547-554.
• 4. Tomlinson JR, Sahn SA. Aspergilloma in sarcoid and tuberculosis. Chest. 1987; 92: 505-508.
• 5. Martens J. Pulmonary aspergilloma, an unusual complication in Wegener's granulomatosis. Postgrad. Med. J. 1982; 58: 55-56.
• 6. Aydemir B, Aydemir C, Okay T, Celik M, Doqusoy I. An aspergilloma in an echinococcal cyst cavity. Thorac. Cardiovasc. Surg. 2006; 54: 353-
• 7. Smith NL, Denning DW. Underlying conditions in chronic pulmonary aspergillosis including simple aspergilloma. Eur. Respir. J. 2011; 37: 865-872.
• 8. Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK. An Official ATS/ERS/JRS/ALAT Statement: Idiopathic Pulmonary Fibrosis: Evidence-based Guidelines for Diagnosis and Management. Am. J. Respir. Crit. Care. Med. 2011; 183: 788-824
• 9. Kim DS, Collard HR, King TE Jr. Classification and natural history of the idiopathic interstitial pneumonias. Proc. Am. Thorac. Soc. 2006; 3: 285-292.
• 10. Soubani AO, Chandrasekar PH. The clinical spectrum of pulmonary aspergillosis. Chest. 2002; 121: 1988-1999.
• 11. Tuncel E. Pulmonary air meniscus sign. Respiration. 1984; 46: 139-144.
• 12. Hirano T, Yamada M, Igusa R, Tanno A, Numakura T, Sakamoto K, et al., Two cases of endobronchial aspergilloma complicated with primary and metastatic lung cancer: A case report and literature review. Respir. Investig. 2016; 54: 211-215.
• 13. Roberts CM, Citron KM, Strickland B. Intrathoracic aspergilloma: role of CT in diagnosis and treatment. Radiology. 1987; 165: 123–128