Endobronchial aspergilloma: report of 10 cases and literature review.

PURPOSE: A retrospective investigation of the clinical and radiologic features as well as the bronchoscopic appearance was carried out in patients with endobronchial aspergilloma. MATERIALS AND METHODS: Ten patients with endobronchial aspergilloma diagnosed by bronchoscopy and histological examination were identified at the Gyeongsang University Hospital of Korea, from May 2003 to May 2009. RESULTS: The patients included 9 men and 1 woman, and the age of the patients ranged from 36 to 76 (median, 58 years). The associated diseases or conditions were: previous pulmonary tuberculosis in 7 patients, lung cancer in 2 patients, pulmonary resection in 1 patient, and foreign body of the bronchus in 1 patient. The chest radiologic finding showed fibrotic changes as a consequence of previous tuberculosis infection in 6 patients and a mass-like lesion in 2 patients. Two patients had a co-existing fungus ball, and an endobronchial lesion was suspected in only 2 patients on the CT scan. The bronchoscopic appearance was a whitish to yellow necrotic mass causing bronchial obstruction in 7 patients, foreign body with adjacent granulation tissue and whitish necrotic tissue in 1 patient, whitish necrotic tissue at an anastomosis site in 1 patient, and a protruding mass with whitish necrotic tissue in 1 patient. CONCLUSION: An endobronchial aspergilloma is a rare presentation of pulmonary aspergilosis and is usually incidentally found in immunocompetent patients with underlying lung disease. It usually appears as a necrotic mass causing bronchial obstruction on bronchoscopy and can be confirmed by biopsy.

Serum angiopoietin-2 levels are elevated during acute exacerbations of COPD.

BACKGROUND AND OBJECTIVE: Recently, angiopoietin-2 (Ang-2) was identified as a ligand of the endothelial receptor tyrosine kinase, Tie-2. Ang-2 is an angiopoietin-1 antagonist that plays a role in vascular destabilization and remodelling, which may increase in some diseases. However, serum Ang-2 levels have not been evaluated in patients with COPD. In this study, we examined serum Ang-2 concentrations in patients experiencing COPD exacerbations and in patients with stable COPD. METHODS: Serum samples were obtained from 49 patients experiencing COPD exacerbations, 22 patients with stable COPD and 18 healthy control subjects. Serum Ang-2 concentrations were measured by ELISA. RESULTS: Serum Ang-2 concentrations were significantly higher in patients with acute exacerbations of COPD than in those with stable COPD or control subjects, and were significantly positively correlated with serum CRP levels but inversely correlated with PaO(2) in patients with exacerbations. In addition, Ang-2 levels decreased significantly after clinical recovery from the acute exacerbation. CONCLUSIONS: Serum Ang-2 levels are significantly elevated during acute exacerbations of COPD, as compared with stable COPD.

A case of anaphylaxis after the ingestion of yacon.

Anaphylaxis is a potentially life-threatening systemic allergic reaction, often with an explosive onset; the symptoms range from mild flushing to upper respiratory obstruction, with or without vascular collapse. Foods are common offending allergens and remain the leading cause of outpatient anaphylaxis in most surveys. Yacon (Smallanthus sonchifolius) is a plant native to the Andes region, where its root is cultivated and consumed mainly as food. Unlike most edible roots, yacon contains large amounts of ructooligosaccharides. Traditionally, yacon tubers have been used as a source of natural sweetener and syrup for people suffering from various disorders. We report the case of a 55-year-old woman who developed syncope and generalized urticaria after ingesting yacon roots. The patient had positive skin prick and intradermal tests to yacon extract. An open food challenge test was performed to confirm food anaphylaxis and was positive 10 minutes after the consumption of yacon roots. To our knowledge, this is the first reported case of anaphylaxis after the ingestion of yacon roots.

Mycobacterium avium complex infection presenting as an endobronchial mass in a patient with acquired immune deficiency syndrome.

Mycobacterium avium complex (MAC) infection is a common opportunistic infection in patients with AIDS (acquired immune deficiency syndrome). Pulmonary involvement of MAC may range from asymptomatic colonization of the respiratory tract to invasive parenchymal or cavitary disease. However, endobronchial lesions with MAC infection are rare in immunocompetent and immunosuppressed hosts. Here, we report MAC infection presenting as an endobronchial mass in a patient with AIDS.