Pulmonary Aspergillosis Mimicking Primary Lung Cancer

Takeshi Saraya*, Takeshi Nosaka, Masachika Fujiwara, Hiroki Nunokawa, Kosuke Ohkuma, Naoki Tsujimoto, Shin Karita, Haruhiko Kondo and Hajime Takizawa

Pulmonary Aspergillosis Mimicking Primary Lung Cancer.

A 68-year-old man was transferred to our hospital because of abnormal lung nodule. He was a social drinker and a current smoker with a history of 70 pack-years. He had no symptoms and was a good
nutritional status. Based on the pulmonary function tests, he was
diagnosed with chronic obstructive lung disease stage II by Global Initiative on Obstructive Lung Disease staging system.

Thoracic Computed Tomography showed the irregular-shaped
nodule measuring 15 mm in size with spiculation at right S1, which accompanied by emphysematous lung changes. On thoracic FDG PET/CT, the nodule demonstrated the intense standardized uptake values
both in the early and delayed phases, suggesting malignancy.

However, video-assisted thoracic surgery biopsied specimens on Hematoxylin and eosin stains showed that the nodule was
consisted of central necrotic component surrounded by microabscesses and fibrotic
granulomatous tissues in which contained filamentous fungi on Grocott’s
methenamine silver stain with calcium oxalate crystal deposition, indicating of pulmonary aspergillosis.

Pulmonary aspergillosis mimicking cancer was an extremely rare event, but should be included in the differential diagnosis for solitary pulmonary nodule. A 68-year-old man was transferred to our hospital because of abnormal lung nodule.

Pulm Res Respir Med Open J. 2015; 2(2): 75-76. doi: 10.17140/PRRMOJ-2-111

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