The Tumour-like Forms of Aspergillosis of the Lung (Pulmonary Aspergilloma): A Report of Five New Cases and a Review of the Portuguese Literature

Allergic aspergillosis: review of 32 cases

“…The predominantly upper lobe distribution of tuberculosis (Royal College of Physicians, 1948) has been considered to be related to poor perfusion of the upper lobes (Boyd, 1965); relative underventilation is probably a more relevant factor in determining the similar distribution of aspergillomas (Villar, Pimentel, and Costa, 1962;Golberg, 1962;Campbell and Clayton, 1964) and of the lesions in allergic aspergillosis, where the fungus is growing within a lung cavity or bronchial lumen. Bronchiectasis of the upper lobes was found in only 1% of patients with known bronchiectasis by Perry and King (1940); although this may underestimate the real prevalence, since gravitational drainage tends to prevent the chronic bacterial infection which usually leads to its recognition, it is generally considered to be uncommon.…”

“…Aspergillomas are thought usually to arise in pre-existing lung cavities or necrotic lesions. Small fungal masses have, however, been demonstrated radiographically in bronchiectatic sacs (Vantrappen, Simons, Woestijne, and Gyselen, 1959), enlargement of aspergillomas and their cavities is well documented (Golberg, 1962;Macartney, 1964), and it is probable that they r*zsult from localized f,ungal growth in any poorly drained lung space (Pesle and Monod, 1954;Segretain, 1962;Villar et al, 1962 …”

“…Aspergillomas are thought usually to arise in pre-existing lung cavities or necrotic lesions. Small fungal masses have, however, been demonstrated radiographically in bronchiectatic sacs (Vantrappen, Simons, Woestijne, and Gyselen, 1959), enlargement of aspergillomas and their cavities is well documented (Golberg, 1962;Macartney, 1964), and it is probable that they r*zsult from localized f,ungal growth in any poorly drained lung space (Pesle and Monod, 1954;Segretain, 1962;Villar et al, 1962). I should like to express my gratitude to all who have helped in the preparation of this paper: to Mary P. English for the mycological studies and for her continued encouragement; to Dr. Peter Watts for his assistance in the review of the radiographs; to Dr. J. E. G. Pearson and all the other physicians, surgeons, and general practitioners who have encouraged me to study patients under their care, …”

Pulmonary Aspergilloma

“…Orie et al (1960) have described 51 cases of pulmonary aspergillosis in the USA, I~of which were aspergillomata. Villar et al (1962) reviewed 30 cases of aspergilloma occurring in Portugal; Campbell and Clayton (1964) investigated 272 patients at B.rompton Hospital, London, 8.5% of whom had ~sperglllo? '~ta.…”

Immunological study of pulmonary aspergilloma

“…Although Monod, Pesle, and Meyer (1957) recognized two distinct stages in the course of pulmonary aspergilloma-one with live fungus and one with dead-it was Pimentel who showed in his numerous publications (Pimentel, 1964(Pimentel, , 1965(Pimentel, , 1966Villar, Pimentel, and Freitas e Costa, 1962) that the fungus grows and dies continuously, this growth and death being partially regulated by the conditions existing in the cavity that contains the fungus (infection, active tuberculosis, etc.). In this continuous process live fungus predominates at times in the fungus ball, but at others dead fungus is more plentiful.…”