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Vol. 30. Issue 9.
Pages 424-432 (November 1994)
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Vol. 30. Issue 9.
Pages 424-432 (November 1994)
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Aspergilomas pulmonares. Análisis de 31 pacientes
Pulmonary aspergilloma. Analysis of 31 patients
Visits
3602
J. Garrós Garay1, E. Ruiz de Gordejuela
Hospital de Santa Marina. Bilbao
F. Vara Quadrado*
* Servicio de Cirugía Torácica. Hospital de Cruces. Baracaldo. Vizcaya
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Se ha realizado un estudio retrospectivo sobre 31 pacientes con aspergilomas pulmonares, destacando como principales hallazgos: 1) el neto predominio de afectación del sexo masculino (90% de los casos); 2) la edad en que se realizó el diagnóstico, con frecuencia significativamente mayor en la quinta y sexta décadas de la vida; 3) el origen de la cavidad asiento del aspergiloma, que correspondió en el 74% de los casos a la tuberculosis pulmonar residual; 4) la elevada incidencia de hemoptisis, que afectó al 87% de los pacientes; 5) el valor diagnóstico de la tomografía tradicional que aportaba imágenes muy orientativas en el 77,4% de los casos, mientras que la radiografía simple sólo lo hacía en el 38,7%; 6) la localización de los aspergilomas, que en un 94% de los casos correspondió a los lóbulos superiores; 7) la presencia de Aspergillus en las secreciones respiratorias, que se obtuvo en el 55% de los casos; 8) las precipitinas a Aspergillus, que fueron positivas en el 94,4% de los casos; 9) el porcentaje de enfermos que no reunían condiciones quirúrgicas mínimas, que ascendió al 48%, y 10) la evolución espontánea, en la que destacan un 13,6% de lisis del aspergiloma y un 9% de hemoptisis mortales.

Palabras clave:
Aspergilomas pulmonares
Tuberculosis pulmonar residual
Hemoptisis
Candida

Thirty-one patients with pulmonary aspergilloma were studied retrospectively, leading to the following main findings: 1) Men are most often affected (90% of cases). 2) Diagnosis occurs significantly more often when the patient is between 50 to 60 years of age. 3) Aspergilloma originates most often in residual pulmonary tuberculosis (74% of cases). 4) The incidence of hemoptysis was high (87% of patients). Traditional tomography afforded images that were diagnostically useful in 77.4% of the cases, whereas simple X-rays were useful in only 38.7%. 6) In 94% aspergilloma occurred in the upper lobes. 7) Aspergillus was found in respiratory secretions in 55%. 8) Serum samples were positive for Aspergillus precipitins in 94.4%. 9) Forty-eight percent did not meet criteria for surgical intervention. 10) Noteworthy features of the course of the disease were that spontaneous lysis occurred in 13.6% and that hemoptysis led to death in 9%.

Key words:
Pulmonary aspergilloma
Residual pulmonary tuberculosis
Hemoptysis
Candida
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Copyright © 1994. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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