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Aspergilloma — SCE Respiratory MCQ

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ModerateRespiratory InfectionsAspergillomaSCE Respiratory

A 59-year-old man with old TB cavities has recurrent haemoptysis. CT shows a mobile intracavitary mass with an air crescent in the right upper lobe and no surrounding invasive disease. Aspergillus IgG is positive. What is the most likely diagnosis?

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Correct answer: A — Simple aspergilloma

A mobile fungal ball within a pre-existing cavity with Aspergillus IgG positivity is a simple aspergilloma. Invasive aspergillosis usually occurs in severe immunosuppression and invades lung tissue. Hydatid disease and malignancy can cavitate but the air-crescent fungal ball in an old TB cavity is characteristic.

Reference: BTS Clinical Statement on Aspergillus-related Lung Disease; ERS CPA Guideline