부산대학교 도서관

Background. Endobronchial aspergillosis remains an insufficiently elucidated disease. Case. A 77-year-old man was admitted to our hospital in October 2009 because of chest pain and atelectasis of the left upper lobe noted on a chest X-ray film. He had a history of lung cancer treated with chemotherapy and stereotactic radiotherapy 5 years previously. Bronchofiberscopy demonstrated mucoid impaction in the left upper bronchus at the site of the previous lung cancer lesion, and Aspergillus was detected on a pathological examination. However, there was no sign of recurrence of lung cancer. Although he had no symptoms of bronchial asthma, bronchial hyper-responsiveness was detected. His laboratory data showed elevated IgE (RIST) and IgE (RAST) levels, but although a skin test for Aspergillus was positive, there was no evidence of bronchiectasis on chest CT findings. Therefore, we diagnosed allergic bronchopulmonary aspergillosis-seropositive (ABPA-S). A mucous plug was removed by bronchofiberscopy and he was treated with itraconazole. Thirteen months later, his X-ray and bronchofiberscopic findings had improved. Conclusion. We report a case of ABPA-S that arose at the site of a previous radiation exposure.