Aspergilloma

This is a patient who presented with a foul smelling cough. Initially, frontal and lateral radiographs of the chest were obtained. The frontal radiograph demonstrates a rounded region of mass-like consolidation in the right upper lobe. This is also well seen on the lateral radiograph. To further characterize the lesion, a CT scan of the chest was obtained. A single axial slice in lung windows is shown. The red arrows demonstrate lucency representing air along the margins of the lesion which is known as the "air crescent" sign. This sign is diagnostic of an aspergilloma, which is also known as a fungus ball. This consolidation represents a collection of a fungus known as Aspergillus within a prexisting lung cavity. The green arrows indicate regions of ground glass consolidation along the margins of the aspergilloma. Histoligically, the ground glass likely represents alveolar hemorrhage due to vascular invasion by the Aspergillus organisms.