Published online Nov 26, 2019. doi: 10.12998/wjcc.v7.i22.3832
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
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.
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.
We highlight that clinicians should consider a diagnosis of invasive aspergillosis when radiological examination shows pseudotumor appearance in diabetes mellitus patients.
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.