Kawamoto Hironori, Suzuki Manabu, Shiozawa Ayako, Miyawaki Eriko, Yamamoto Shota, Kobayashi Konomi, Takasaki Jin, Takeda Yuichiro, Hojo Masayuki, Sugiyama Haruhito
Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan.
Department of Respiratory Medicine, Jikei University Hospital, Japan.
Intern Med. 2018 Feb 1;57(3):377-381. doi: 10.2169/internalmedicine.8967-17. Epub 2017 Nov 1.
Development of aspergilloma is common in cases with a fungus ball-like shadow in cavities due to old tuberculosis. Some reports have shown that blood clots tend to appear as a fungus ball-like shadow. A 71-year-old man with a history of pulmonary tuberculosis presented with a fungus ball-like shadow in an old cavity and hemoptysis. There was no evidence of aspergillus infection on various examinations. We confirmed a blood clot and aneurysm of an artery under direct vision by bronchoscopy. A lateral thoracic artery aneurysm was detected by angiography. Transcatheter arterial embolization was performed. After treatment, the artery aneurysm disappeared.
曲霉球在陈旧性肺结核导致空洞内出现真菌球样阴影的病例中很常见。一些报告表明,血凝块往往表现为真菌球样阴影。一名有肺结核病史的71岁男性,在陈旧性空洞内出现真菌球样阴影并伴有咯血。各项检查均未发现曲霉菌感染的证据。我们通过支气管镜直视确认了血凝块和动脉动脉瘤。血管造影检测到胸外侧动脉动脉瘤。进行了经导管动脉栓塞术。治疗后,动脉动脉瘤消失。