Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2019; 7(22): 3832-3837
Published online Nov 26, 2019. doi: 10.12998/wjcc.v7.i22.3832
Invasive aspergillosis presenting as hilar masses with stenosis of bronchus: A case report
Shan-Shan Su, Ying Zhou, Han-Yan Xu, Ling-Ping Zhou, Cheng-Shui Chen, Yu-Ping Li
Shan-Shan Su, Ying Zhou, Han-Yan Xu, Ling-Ping Zhou, Cheng-Shui Chen, Yu-Ping Li, Key Laboratory of Intervention Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, Zhejiang Province, China
Author contributions: Su SS and Zhou LP were the patient’s physicians, reviewed the literature and contributed to manuscript drafting; Zhou Y reviewed the literature and contributed to manuscript drafting; Xu HY interpreted the imaging findings and contributed to manuscript drafting; Chen CS and Li YP were responsible for the revision of the manuscript for important intellectual content. All authors issued final approval for the version to be submitted.
Supported by Wenzhou Municipal Science and Technology Bureau, No. ZH2017001.
Informed consent statement: Informed consent statement was obtained from the reported patient.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yu-Ping Li, MD, Professor, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Ouhai District, Wenzhou 325015, Zhejiang Province, China. wzliyp@163.com
Telephone: +86-577-55579273 Fax: +86-577-55579273
Received: July 7, 2019
Peer-review started: July 17, 2019
First decision: September 23, 2019
Revised: October 4, 2019
Accepted: October 15, 2019
Article in press: October 15, 2019
Published online: November 26, 2019
Abstract
BACKGROUND

Hilar masses with stenosis of the bronchus occur mainly due to malignant diseases, such as lung cancer. Hilar masses resulting from invasive aspergillosis are extremely rare and occur mostly in severely immunosuppressed patients.

CASE SUMMARY

In the current case report, we have documented a unique case of invasive aspergillosis presenting as a mass in the hilum and bronchial stenosis under bronchoscopy mimicking lung cancer in a 54-year-old man with diabetes mellitus. The histological analysis of bronchial membrane biopsy demonstrated fungal elements of 45° branching hyphae with positive Periodic Acid-Schiff and Grocott staining. After 3 mo of antifungal therapy, the symptoms, computed tomography scan and bronchoscopy manifestations all showed improvement.

CONCLUSION

We highlight that clinicians should consider a diagnosis of invasive aspergillosis when radiological examination shows pseudotumor appearance in diabetes mellitus patients.

Keywords: Invasive aspergillosis, Lymph nodes, Lung cancer, Bronchoscopy, Case report

Core tip: Hilar masses with stenosis of the bronchus occur mainly due to malignant diseases. Hilar masses resulting from invasive aspergillosis are extremely rare and occur mostly in immunosuppressed patients. Herein, we have documented a case of invasive aspergillosis presenting as a mass in the hilum and bronchial stenosis under bronchoscopy in a 54-year-old man with diabetes mellitus. We have highlighted the importance of bronchoscopy with biopsy and culture for early diagnosis and treatment when radiological examination shows pseudotumor appearance in diabetes mellitus patients.