PMC5832132_01
Chest CT scan transverse view. The aspergilloma cavity is seen at the apex of the right lung. There are massive pneumothorax with subcutaneous emphysema and bilateral lung fibrosis as sequelae of tuberculosis.
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It revealed a massive pneumothorax with subcutaneous emphysema on the right side associated with a typical complex aspergilloma cavity well defined at the right lung apex (Figures 1 and 2).
Chest CT scan frontal view. The aspergilloma is seen in the apical region. There is extensive subcutaneous emphysema bilaterally. The upper lobe is totally destroyed, the middle lobe is fibrotic, and the lower lobe is atelectatic and retracted. There are massive pneumothorax, bilateral fibrosis, and sequelae of tuberculosis mainly at the left apex.
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It revealed a massive pneumothorax with subcutaneous emphysema on the right side associated with a typical complex aspergilloma cavity well defined at the right lung apex (Figures 1 and 2).
Picture showing the patient with massive subcutaneous emphysema despite 2 chest tubes inserted.
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The physical exam revealed an anxious patient with severe dyspnoea and massive subcutaneous emphysema (diffuse subcutaneous air with tympanic chest, all over the trunk and the cervical and scrotal regions as seen in Figure 3).
Photo of the specimen. Inside the aspergilloma cavity, a large cavity communicating with the main bronchus is shown, and the aspergilloma truffe has been removed from the cavity.
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There were no visible bullae (Figure 4).
Chest X-ray after 17 months showing a fully expanded lower lobe and the same fibrosis in both lungs with no change.
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He was seen as outpatient for regular follow-up and did not receive any more antituberculosis medication because the pathology did not show signs of persistent active disease; this was confirmed on the follow-up chest radiograph 17 months later (Figure 5).