After completing his tuberculosis treatment regimen and testing negative, Hoang stopped his follow-up appointments. Over the past year, he frequently suffered from respiratory infections, with persistent and recurrent coughing. Last month, his cough worsened, sometimes producing blood. He was diagnosed with pulmonary aspergilloma and transferred to Tam Anh General Hospital, Ho Chi Minh City, for specialized treatment.

Master of Science, Doctor, First Degree Specialist Phan Vu Hong Hai, from the Thoracic and Vascular Surgery Center, explained that pulmonary aspergilloma is a mass formed by fungal species growing in damaged lung cavities. A humid environment and poor air circulation create favorable conditions for the growth of Aspergillus fungus. In individuals with weakened immune systems or chronic lung conditions such as pulmonary tuberculosis, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, bronchial cysts, or lung cancer, the lung parenchyma provides an ideal environment for fungal bacteria to thrive. Pulmonary aspergilloma is a common sequela in patients with a history of pulmonary tuberculosis.

In Hoang's case, a tuberculosis lesion measuring 53x58x66 mm occupied his entire upper lobe, and another measuring 14x21x18 mm affected a portion of his right lung's lower lobe. Inside these lesions was a fungal mass that moved with the patient's breathing. According to Doctor Hai, this caused persistent lung inflammation and coughing.

Doctors perform endoscopic surgery to address lung damage in a patient. Photo: Jaker Min

Doctor of Science, Doctor Nguyen Anh Dung, Head of the Department of Thoracic and Vascular Surgery at Tam Anh General Hospital, Ho Chi Minh City, and his team performed minimally invasive surgery to remove the pulmonary aspergilloma. Through three incisions, each approximately 0,5-1 cm on the abdomen, doctors separated the adhesions between the parietal pleura and visceral pleura, creating sufficient space for endoscopic instruments. After two hours, the entire fungal mass was removed, and the damaged lung tissue was resected. The patient resumed normal activities, received breathing exercises, and was discharged after three days.

According to Doctor Hai, if pulmonary aspergilloma is not detected and treated promptly, it can progress rapidly, leading to fatigue and exhaustion. The tumor can also proliferate, causing continuous pneumonia. Sometimes, pulmonary aspergilloma presents no symptoms and is discovered incidentally on a chest X-ray. Individuals with high-risk factors, such as a history of pulmonary tuberculosis, chronic lung disease, or a weakened immune system, should seek medical attention immediately if they experience symptoms like coughing up blood, shortness of breath, fever, fatigue, or weight loss. Prevention involves avoiding moldy environments and wearing a mask to prevent exposure to Aspergillus fungus.

Thu Ha

*Patient's name has been changed