Aspergilloma is the most common form of aspergillosis. It occurs in hosts with normal immunity, and the fungus colonizes preexisting cavities (cysts, tuberculous cavities, cystic bronchiectasis) and forms a fungus ball. This may erode the cavity wall both mechanically and through enzymatic action and lead to hemoptysis. The chest radiograph shows a round, homogeneous opacity which is mobile within the cavity. A circular or crescent-shaped air space may be visible between the mycetoma and the cavity wall. Localized pleural thickening may be seen adjacent to the cavity, indicating superimposed aspergillus infection. CT will show the mycetoma of inhomogeneous attenuation and the surrounding crescent of air within the cavity The mobility of the intracavitary mass may be demonstrated by image acquisition in the prone position. The mycetoma has a characteristic sponge-like appearance and contains multiple foci of air.
