Bronchiale Aspergillosen[1]

Zusammenfassung

Bronchopulmonale Aspergillosen nehmen an Häufigkeit zu, sind oft schwierig zu diagnostizieren und können heute mit modernen Antimykotika besser behandelt werden als früher. Sie sind daher von aktuellem Interesse. Dies betrifft auch die bronchialen Aspergillosen, die Thema der vorliegenden Arbeit sind und seltener sind als die pulmonalen. Insgesamt werden 39 Patienten mit bronchialen Aspergillosen vorgestellt: 1.) 4 Fälle mit endobronchialen Aspergillomen, zwei davon bronchoskopisch sichtbar, 2.) ein Fall mit chronischer nekrotisierender pulmonaler Aspergillose (CNPA), bei dem ein Bronchus nekrotisierte, 3.) eine invasive Aspergillose im Bereich einer bronchialen Anastomose, 4.) 7 Fälle mit einer Aspergillusinvasion von endobronchialem Tumorgewebe und 5.) 26 Fälle mit allergischer bronchopulmonaler Aspergillose (ABPA). Schwerpunkt der Arbeit sind bronchoskopische und radiologische Befunde. 37 der 39 Fälle sind Teil einer retrospektiven Single Center-Studie mit insgesamt 116 konsekutiven bronchopulmonalen Aspergillosen, die über 7 Jahre gesammelt wurden.

Abstract

Bronchopulmonary aspergillosis is becoming more frequent, is often hard to diagnose and with todays antimycotics better to treat than before. It is therefore of current interest. This also concerns bronchial aspergillosis which is less common than pulmonary aspergillosis and the topic of this paper. A total of 39 patients with bronchial aspergillosis are presented: 1) 4 cases with endobronchial aspergilla, two which are visual bronchoscopically, 2) one case with chronic necrotising pulmonary aspergillosis (CNPA), where a bronchus has necrotised, 3) an invasive aspergillosis in the region of a bronchial anastomosis, 4) 7 cases with an Aspergillus invasion from endobronchial tumour tissue and 5) 26 cases with allergic bronchopulmonary aspergillosis (ABPA). 37 of the 39 cases are part of a single centre study with a total of 116 bronchopulmonary aspergilloses, which were collected over seven years. The focus of attention in this paper is on the bronchoscopic and radiological results.

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1 Herrn Prof. Dr. Rainer Dierkesmann, dem langjährigen klinischen Direktor der Klinik Schillerhöhe nachträglich zum 65. Geburtstag