Postsurgical mediastinal aspergilloma masquerading as malignancy

Saira Farid, Omar AbuSaleh, Nana Aburjania, Muhammad Rizwan Sohail

Research output: Contribution to journalArticlepeer-review


A 70-year-old man with non-ischaemic dilated cardiomyopathy presented with symptoms of fatigue, chills and unintentional weight loss over the past 2 months. Initial evaluation revealed anaemia, peripheral leucocytosis and elevated inflammatory markers. Results of an oesophagogastroduodenoscopy, colonoscopy, blood bacterial and fungal cultures and bone marrow biopsy were negative. An 18F-FDG positron-emission tomography-CT demonstrated an indeterminate, intensely FDG-avid 5 cm × 2 cm × 5.6 cm × 6.7 cm mass centred within the junction of the superior vena cava and right atrium, suggestive of probable malignancy versus an inflammatory thrombus. After multidisciplinary consideration, patient underwent a diagnostic minithoracotomy and a thick fibrotic mediastinal mass was visualised and evacuated. The encapsulated mass contained thick, white creamy liquid that appeared to be purulent/necrotic material. The biopsies of the capsule wall on frozen section demonstrated fungal elements consistent with Aspergillosis species. Fungal culture confirmed diagnosis of Aspergillus fumigatus.

Original languageEnglish (US)
Article numberbcr-2017-221140
JournalBMJ case reports
StatePublished - 2017


  • cardiothoracic surgery
  • infectious diseases

ASJC Scopus subject areas

  • Medicine(all)


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