대한흉부영상의학회 Weekly Chest Cases

Case No : 1190 Date 2020-08-11

Courtesy of Hye Young Kwon, Sung Shine Shim, Woocheol Kwon / Ewha Womans University Seoul Hospital
Age/Sex 68 / M
Chief Complainthemoptysis, cough (2 days)

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initial chest X-ray

Diagnosis With Brief Discussion

Diagnosis: Subacute invasive pulmonary aspergillosis
Radiologic Findings: Figure 1. Multiple small nodules are noted in both lungs with cavitary consolidation in right apex.
Figure 2-3. An approximately 4.5cm-sized thick walled cavity with adjacent fibrotic bands is seen in right upper lobe with randomly distributed multiple small nodules in both upper lobes.
Figure 4. On chest X-ray after 1 year, there is increasing cavitary consolidation in RULZ while other findings remain constant.
Figure 5-8. Chest CT scans after 1 year show substantially thickened wall of the cavity with unchanged multiple nodules in both upper lobes.

The patient had a history of tuberculosis and pneumoconiosis. Aspergillus fumigatus was detected in culture by PCNA, and a definitive diagnosis of subacute invasive pulmonary aspergillosis was made.
Brief Review: Subacute invasive pulmonary aspergillosis (SIPA) is a rapidly progressive fungal infection lasting fewer than three months and arising from pre
Please refer to
References: 1. Barac A, Kosmidis C, Alastruey-Izquierdo A, et al. Chronic pulmonary aspergillosis update: A year in review. Med Mycol. 2019 Apr 1;57(Supplement_2):S104-S109
2. Kanj A, Abdallah N, Soubani AO. The spectrum of pulmonary aspergillosis. Respir Med. 2018 Aug;141:121-131
3. Denning DW, Cadranel J, Beigelman-Aubry C, et al. Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. Eur Respir J. 2016 Jan;47(1):45-68.
Keywords: lung, chronic pulmonary aspergillosis, subacute invasive pulmonary aspergillosis,

No. of Applicants : 61

▶ Correct Answer : 11/61, 18.0%

- Tiger Gate Hospital , Japan SHIN-ICHI CHO
- Vita Hospital , Brazil DIOGO LAGO PINHEIRO
- Osaka City General Hospital , Japan SHU MATSUSHITA
- University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
- Eskisehir Sehir Hastanesi , Turkey MURAT SAHIN
- Fortis hospital , Mohali , India SHALEEN RANA
- Toranomon Hospital , Japan KAORU SUMIDA
- , Japan KAZUMA TERAUCHI
- Private sector , Greece VASILIOS TZILAS
- Chonnam National University Hwasun Hospital , Korea (South) WONGI JEONG
- Jiangsu province hospital , China WANGJIAN ZHA

▶ Correct Answer as Differential Diagnosis : 12/61, 19.7%

- Mayo Clinic , United States AKITOSHI INOUE
- CH de la Cote Basque , France PAUL ARDILOUZE
- Hamamatsu University Hospital , Japan HAYATO NOZAWA
- , Japan YASUSHI AOYAGI
- Gifu University Hospital , Japan Yo Kaneko
- Mayo Clinic , Japan HIROAKI TAKAHASHI
- Diskapi Yildirim Beyazit Hospital, Ankara , Turkey MERIC TUZUN
- Suita Tokushukai Hospital , Japan JUNKO OCHI
- Nishida Hospital , Japan SHOJI OKUDA
- National Center for Global Health and Medicine , Japan HIROSHI TAKUMIDA
- , Japan YUMI MAEHARA
- Hamamatsu University Hospital , Japan YUKI HAYASHI

▶ Semi-Correct Answer : 12/61, 19.7%

- Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
- Ondokuz Mayis University , Turkey CETIN CELENK
- Scans world , India PHILSON JOSEPH MUKKADA
- Seoul Medical Center , Korea (South) HYUK GI HONG
- The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
- Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
- Chungbuk National University Hospital , Korea (South) JUNGHWAN KIM
- The University of Tokyo Hospital , Japan RYO KUROKAWA
- Asan Medical Center , Korea (South) JIHOON KIM
- Other , Korea (South) KYU-CHONG LEE
- Post graduate , India SHASHI KUMAR ANBAZHAGAN
- University of Tsukuba Hospital , Japan SODAI HOSHIAI

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 1190 Date 2020-08-11

Discussion

No. of Applicants : 61