HomeCirculationVol. 114, No. 17Neovascularization From Coronary Artery Leaking to Fungus Ball in the Lung Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReview ArticlePDF/EPUBNeovascularization From Coronary Artery Leaking to Fungus Ball in the Lung Kwang Kon Koh, MD, Seung Hwan Han, MD, Jeong Ho Kim, MD, Sang Jin Lee, MD and Jin Yong Kim, MD Kwang Kon KohKwang Kon Koh From the Division of Cardiology, Gil Heart Center (K.K.K., S.H.H., S.J.L., J.Y.K.), and Division of Cardiovascular Imaging and Interventional Radiology, the Department of Radiology (J.H.K.), Gachon Medical School, Incheon, Korea. Search for more papers by this author , Seung Hwan HanSeung Hwan Han From the Division of Cardiology, Gil Heart Center (K.K.K., S.H.H., S.J.L., J.Y.K.), and Division of Cardiovascular Imaging and Interventional Radiology, the Department of Radiology (J.H.K.), Gachon Medical School, Incheon, Korea. Search for more papers by this author , Jeong Ho KimJeong Ho Kim From the Division of Cardiology, Gil Heart Center (K.K.K., S.H.H., S.J.L., J.Y.K.), and Division of Cardiovascular Imaging and Interventional Radiology, the Department of Radiology (J.H.K.), Gachon Medical School, Incheon, Korea. Search for more papers by this author , Sang Jin LeeSang Jin Lee From the Division of Cardiology, Gil Heart Center (K.K.K., S.H.H., S.J.L., J.Y.K.), and Division of Cardiovascular Imaging and Interventional Radiology, the Department of Radiology (J.H.K.), Gachon Medical School, Incheon, Korea. Search for more papers by this author and Jin Yong KimJin Yong Kim From the Division of Cardiology, Gil Heart Center (K.K.K., S.H.H., S.J.L., J.Y.K.), and Division of Cardiovascular Imaging and Interventional Radiology, the Department of Radiology (J.H.K.), Gachon Medical School, Incheon, Korea. Search for more papers by this author Originally published24 Oct 2006https://doi.org/10.1161/CIRCULATIONAHA.106.630657Circulation. 2006;114:e551–e552A 68-year-old woman came to the clinic for evaluation of an operation risk. She had the sensation of a mass in her abdomen for 10 years, and ventral hernia was diagnosed. Her weight was 96 kg and her height was 157 cm; her body mass index was 38.95 kg/m2. She had a history of diabetes for 3 years. She also had a history of aspergillosis, which had been cured 10 years ago. She reported no chest pain on exercise. Chest radiography demonstrated a fungus ball in the left upper lung (Figure 1). Radionuclide imaging (technetium 99m sestamibi scan) showed reversible, moderate-sized perfusion defects in the apical to mid-inferior area, suggesting right coronary artery lesion. The echocardiogram showed no abnormal findings. The coronary angiogram revealed neovascularization from the distal left circumflex artery and proximal right coronary artery to the left upper lung (Figure 2). There was no significant stenosis in the left and right coronary arteries. To confirm the site where the neovascularization leaked, we performed a multislice computed coronary angiogram. Axial images of the thorax in the mediastinal and lung settings showed close proximity between the left atrioventricular groove and a cavity mass. However, we failed to observe clear neovascularization flow because of the patient’s body fat and because the vessels had a very thin diameter. Instead, we confirmed a definite fungus ball in the left upper lung (Figure 3). We concluded neovascularity from both coronary arteries leaking to a fungus ball in the left lung. Download figureDownload PowerPointFigure 1. Posteroanterior view of the chest film showed a round mass with surrounding crescent air shadow in the upper left lung field (arrows), a finding compatible with fungus ball.Download figureDownload PowerPointFigure 2. Coronary angiogram revealed neovascularization from the distal left circumflex artery (A) and the proximal right coronary artery (B) to the left upper lung.Download figureDownload PowerPointFigure 3. Axial images of thorax with mediastinal (A) and lung settings (B) show close proximity between the left atrioventricular groove (arrowhead) and a cavity mass (arrows). However, neovascularization could not be seen in this image because of the very thin diameter of the vessels. The mass had eccentric, nonenhanced soft tissue density and crescent air density, typical radiological findings highly suggestive of fungus ball.DisclosuresNone.FootnotesCorrespondence to Kwang Kon Koh, MD, FACC, FAHA, Vascular Medicine and Atherosclerosis Unit, Cardiology, Gil Heart Center, Gachon Medical School, 1198 Kuwol-dong, Namdong-gu, Incheon, Korea 405–760. E-mail [email protected] Previous Back to top Next FiguresReferencesRelatedDetailsCited By (2013) Engineering and Sport Exercising Computational Modeling for Anthropometry, 10.1201/b15763-6, (65-83), Online publication date: 18-Sep-2013. Guazzelli L, Severo C, Hoff L, Pinto G, Camargo J and Severo L (2012) Bola fúngica por Aspergillus fumigatus em cavidade pleural, Jornal Brasileiro de Pneumologia, 10.1590/S1806-37132012000100017, 38:1, (125-132), Online publication date: 1-Feb-2012. October 24, 2006Vol 114, Issue 17 Advertisement Article InformationMetrics https://doi.org/10.1161/CIRCULATIONAHA.106.630657PMID: 17060390 Originally publishedOctober 24, 2006 PDF download Advertisement SubjectsComputerized Tomography (CT)Imaging