[A case of pulmonary aspergillosis with a tumor shadow, diagnosed by transbronchial aspiration cytology].

A 41-year-old female was admitted because of cough and hemosputum. She had no underlying disease and the presence of respiratory disease had not been pointed out. Chest X-ray and CT scan showed a solid, homogeneous tumor with a distinct margin near the right hilum. The tumor measured approximately 5 x 4 cm. Because other laboratory data concerning the serum levels of tumor marker and anti-aspergillus antibody were normal, benign lung tumor or malignant lymphoma was suspected at first. Transbronchial cytology and biopsy were performed, but there were no significant findings. However transbronchial aspiration cytology of the specimen obtained from the bifurcation between the right upper lobe bronchus and the truncus intermedius demonstrated Aspergillus. After the administration of antifungal drugs, the tumor decreased in size, and an air crescent sign appeared. This was thought to be a very rare case of locally invasive form of pulmonary aspergillosis, as described by Sider et al demonstrating a necrotic fungal ball during its clinical course.