Postsurgical mediastinal aspergilloma masquerading as malignancy

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

Research output: Contribution to journalArticle

Abstract

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
Volume2017
DOIs
StatePublished - 2017

Keywords

  • cardiothoracic surgery
  • infectious diseases

ASJC Scopus subject areas

  • Medicine(all)

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    Farid, S., AbuSaleh, O., Aburjania, N., & Sohail, M. R. (2017). Postsurgical mediastinal aspergilloma masquerading as malignancy. BMJ case reports, 2017, [bcr-2017-221140]. https://doi.org/10.1136/bcr-2017-221140