Abstract
Chronic necrotizing pulmonary aspergillosis is characterized by a pulmonary infiltration with cavitation in patients with chronic pulmonary disease, slight immunodeficiency or healthy patients. A 57-year-old man with non-small cell carcinoma who has had radiotherapy was admitted with a history of left side pleuritic chest pain, non-productive cough, fever and dyspnea. Aspergillus fumigatus was found in his mycological exams of BAL fluid. Serum examination presented positive galactomannan. Final diagnosis was semi-invasive pulmonary aspergillosis treated with voriconazole.
Highlights
Chronic necrotizing pulmonary aspergillosis (CNPA), called semi-invasive pulmonary aspergillosis, was first described in the early 1980s as a distinct type of pulmonary aspergillosis [1]
There are a few reports in the literature that semiinvasive aspergillosis can occur in adults following radiotherapy [3,4]
We presented chronic necrotizing pulmonary aspergillosis in a patient with non-small cell lung carcinoma (NSCLC) following radiotherapy
Summary
Chronic necrotizing pulmonary aspergillosis (CNPA), called semi-invasive pulmonary aspergillosis, was first described in the early 1980s as a distinct type of pulmonary aspergillosis [1]. We presented chronic necrotizing pulmonary aspergillosis in a patient with non-small cell lung carcinoma (NSCLC) following radiotherapy. A 57-year-old man was admitted to our pulmonary outpatient clinic with a history of left side pleuritic chest pain, non-productive cough, fever and dyspnea for 3 days He was diagnosed NSCLC nine months ago. Chest radiology revealed a cavitary lesion of middle and lower lung field (Figure 1) and on HRCT there was a 50×37 mm solid mass lesion in the left hilum surrounding left upper bronchus (Figure 2) and 12×8 cm cavitary lesion on the segments of the left lung lobe with air-liquid level (Figure 3) He was used different therapy of antibiotics for a month but there was no clinical response to that treatment. Our final diagnosis was semiinvasive pulmonary aspergillosis and we started him on voriconazole (400 mg per day, orally)
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