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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 345:443-449 August 9, 2001 Number 6
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Case 24-2001— A 46-Year-Old Woman with Chronic Sinusitis, Pulmonary Nodules, and Hemoptysis
John F. Beamis, M.D., and Eugene J. Mark, M.D.

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Presentation of Case

A 46-year-old woman was admitted to the hospital because of recurrent hemoptysis.

Eight months earlier, a cough, nonpleuritic left-sided chest pain, and fatigue had developed, with minor episodes of hemoptysis. A tuberculin skin test was positive, with 20 mm of induration. A computed tomographic (CT) scan of the thorax performed elsewhere was said to show evidence of distal bronchiectasis and mucoid impaction. Sputum examination revealed no acid-fast bacilli. The following month, bronchoscopic examination showed no abnormalities, and culture of bronchoalveolar-lavage fluid yielded a single colony of Aspergillus niger and was negative for acid-fast bacilli. Isoniazid and rifampin were administered for . . . [Full Text of this Article]

Differential Diagnosis

Sinopulmonary Syndromes

Allergic Fungal Sinusitis

Allergic Bronchopulmonary Aspergillosis

Conclusions

Clinical Diagnoses

Dr. John F. Beamis's Diagnosis

Pathological Discussion

Anatomical Diagnoses

References


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