A Case of Endobronchial Aspergilloma Associated with Foreign Body in Immunocompetent Patient without Underlying Lung Disease
A 59-year-old man visited with recurrent hemoptysis for 5 months. He was a never-smoker and had no underlying disease. Patient had aspiration history of chicken bone 3 years ago, but no loss of consciousness. On admission, he presented with 110/70 mm Hg of blood pressure, 75 beats per minute of heart rate, 20 breaths per minute of respiratory rate, 36.0℃ of body temperature. Lymph node in neck was not palpated. Physical examination of chest revealed no crackle or wheezing. Complete blood count results were white blood cell 6,800/mm3 (neutrophils 56%, lymphocytes 33%, monocytes 8%, and eosinophils 3%), hemoglobin 15.4 g/dL, and platelet 195,000/mm3. Routine blood chemistries and tumor makers were within normal limits. Human immunodeficiency virus antibody test was negative.\nChest X-ray showed a nodular opacity in left hilar field (). Computed tomography (CT) scan of chest revealed a 2.4×1.8 cm-sized spiculated mass and surround small nodular opacities in superior segment of left lower lobe (). Fiberoptic bronchoscopy re vealed an irregular mass-like, brownish material which totally obstruct subsegmental bronchus () and a foreign body in superior segmental bronchus of left lower lobe (). We repeatedly tried removing a foreign body, but could not succeed because it was impossible to be held by forceps or snare within narrow lumen. Histopathologic examination of bronchoscopic biopsy specimen showed mostly fungal hyphae ().