Complex bilateral upper lobe aspergilloma

Abstract

A 39-year-old woman, who had been treated for pulmonary Koch's 15 years earlier, presented with hemoptysis of 18 months duration. Computed tomography in scout view showed bilateral upper lobe masses (Figure 1), which were in fact fibrosis and cavitations, with a mass surrounded by air (crescent sign), typical of aspergilloma, seen on a chest computed tomography scan (Figure 2). She had taken fluconazole for 6 months without any relief before coming for surgery. She underwent a median sternotomy and bilateral upper lobectomies with good postoperative recovery (Figure 3).