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All the chest radiographs taken in Argyll from 1954 to 1963 have been investigated and the fifty-six patients found to have residual tuberculous or other cavitation, with or without any suggestion of aspergilloma, have been examined further. Six of these (approximately one in ten) were discovered to have pulmonary aspergillomas. Four were related to previous pulmonary tuberculosis and two to previous pulmonary abscess.
Radiology and serology were the most rewarding methods of investigatin. When the lesion was situated posteriorly in the upper zone, coned lordotic views were the best method of demonstrating the fungal mass. Serum precipitins against Asp. fumigatus were present in all six cases which had radiological evidence. In three of the cases the finding of a positive precipitin test actually led to the intensive radiological search whereby the aspergilloma was demonstrated.
The comparatively high yield in this survey suggests that the wider use of precipitin tests and coned lordotic views in appropriate patients would result in more aspergillomas being diagnosed.
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© 1965 Ballière, Tindalli & Cassell. Published by Elsevier Inc.