Multimedia
 | Media file 1: Microscopic slide of lung tissue. This image shows broad hyphae, which branch at acute angles. |
 | Media file 2: Section of a blood vessel. This image shows branching fungal hyphae that invade the vessel wall. |
 | Media file 3: Posteroanterior chest radiograph in a patient with allergic bronchopulmonary aspergillosis. This image shows branching finger-in-glove tubular opacities in the left lower lobe (ie, retrocardiac location) due to mucus plugging of ectatic bronchi. |
 | Media file 4: High-resolution computed tomography scan (same patient as in Image 3). This image shows peribronchial thickening and apparent nodular opacities in the lower lobes due to bronchiectasis with mucoid impaction. |
 | Media file 5: High-resolution computed tomography scan shows central bronchiectasis in a patient with allergic bronchopulmonary aspergillosis. The patient had previously undergone left upper lobectomy for severe bronchiectasis. |
 | Media file 6: Posteroanterior chest radiograph shows multiple aspergillomas in a patient with tuberculosis. Note the numerous air crescents. |
 | Media file 7: Posteroanterior chest radiograph shows chronic, cavitating, upper lobe consolidation in a patient with long-standing fibrosing alveolitis; this finding is consistent with chronic necrotizing aspergillosis. Aspergillus fumigatus was cultured from the sputum and percutaneous aspiration samples. |
 | Media file 8: Axial computed tomography scan obtained at the level of the aortic arch (same patient as in Image 7). This image shows a masslike consolidation, with a developing air crescent adjacent to the central sequestrated lung, which mimics a mycetoma. |
 | Media file 9: Axial nonenhanced computed tomography scan obtained through the lower thorax. This image shows a subtle left lower lobe nodule due to invasive aspergillosis in a renal transplant recipient. The patient had multiple other nodules, one of which was examined at biopsy to confirm the diagnosis. Note the esophagus has thickened walls secondary to concurrent cytomegaloviral infection. |
 | Media file 10: Posteroanterior chest radiograph shows a left upper lobe mycetoma with an indwelling catheter for drug delivery. |
 | Media file 11: Flush thoracic aortogram obtained in a patient with a mycetoma and hemoptysis. This image shows anastomosis involving the bronchial artery, intercostal arteries, and pulmonary artery. Note also the anastomosis with blood vessels from the lateral thoracic wall. |
 | Media file 12: Right bronchial angiogram in a 40-year old man with a known right lung mycetoma (arrow). This image shows extensive anastomosis between the right bronchial artery and the intercostal arteries. |
 | Media file 13: This posteroanterior chest radiograph was obtained in a 36-year-old woman who was previously treated for pulmonary tuberculosis (same patient in Images 13-18). The patient had a left upper lobe mycetoma and presented with recurrent life-threatening hemoptysis. The disease failed to respond to systemic and local antifungal therapy. |
 | Media file 14: Angiogram of the left thyrocervical trunk in a 36-year-old woman with a left upper lobe mycetoma and a past history of being treated for pulmonary tuberculosis (same patient in Images 13-18). This image shows that the blood supply to the mycetoma is derived from the thyrocervical trunk. |
 | Media file 15: Delayed-phase angiogram in a 36-year-old woman with a left upper lobe mycetoma and a past history of being treated for pulmonary tuberculosis (same patient in Images 13-18). This image shows anastomosis of the branches of the thyrocervical trunk with the left pulmonary artery at the site of the mycetoma. |
 | Media file 16: Angiographic series of the thyrocervical trunk in a 36-year-old woman with a left upper lobe mycetoma and a past history of being treated for pulmonary tuberculosis (same patient in Images 13-18). This image was obtained after embolization and shows a pruned-tree appearance of the arterial trunks. Note that the left internal mammary artery had to be sacrificed. |
 | Media file 17: Angiogram of the right fifth intercostal artery in a 36-year-old woman with a left upper lobe mycetoma and a past history of being treated for pulmonary tuberculosis (same patient in Images 13-18). This image shows that the artery meanders around to the left hemithorax and supplies the left-sided mycetoma. |
 | Media file 18: Angiogram of the right 5th intercostal artery in a 36-year-old woman with a left upper lobe mycetoma and a past history of being treated for pulmonary tuberculosis (same patient in Images 13-18). This image shows the blind stump of the artery after embolization. When this article was written, the patient was alive and well and had had no further episodes of hemoptysis for more than 3 years. |
More on Aspergillosis, Thoracic |
| Overview: Aspergillosis, Thoracic |
| Imaging: Aspergillosis, Thoracic |
| Follow-up: Aspergillosis, Thoracic |
 Multimedia: Aspergillosis, Thoracic |
| References |
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Further Reading
Keywords
pulmonary aspergillosis, Aspergillus fumigatus, A fumigatus, allergic bronchopulmonary aspergillosis, ABPA, saprophytic aspergillosis, aspergilloma, chronic necrotizing aspergillosis, airway-invasive aspergillosis, semi-invasive aspergillosis, angioinvasive aspergillosis, finger-in-glove sign, tree-in-bud sign, air-crescent sign
