Association between Pulmonary Aspergillosis and Bronchogenic Carcinoma: Report of Two Cases

Abstract

The association between bronchogenic carcinoma and pulmonary aspergilloma is uncommon but clinically significant, particularly in tuberculosis-endemic regions where residual lung cavities are frequent. The coexistence of these two conditions poses important diagnostic and therapeutic challenges due to overlapping clinical and radiological features and may lead to delayed cancer diagnosis. We report two cases involving 64- and 67-year-old former chronic smokers with a history of treated pulmonary tuberculosis who presented with hemoptysis, chest pain, and deterioration of general condition. Thoracic computed tomography revealed pulmonary masses associated with a typical air-crescent (Monod) sign. Histological confirmation of lung cancer was obtained by pleural biopsy in the first case and by transthoracic biopsy in the second, revealing primary pulmonary adenocarcinoma in both patients. Aspergillus serology was positive in both cases, with different clinical outcomes depending on tumor stage and operability. These cases highlight the need for systematic evaluation for malignancy in patients presenting with pulmonary aspergilloma.