Pulmonary Aspergilloma with Oxalosis.

A 37-year-old man presented with a 3-month history of cough and dyspnea. His medical history included right rib fracture and lung contusion caused by lion bites at 20 years of age. Chest radiography (Picture 1A) and computed tomography of the chest (Picture 1B, C) showed a mass within the lung cavity and consolidation at the right apex, suggesting pulmonary aspergilloma. The laboratory and bronchoscopic findings were not contributory. However, cytological examinations of the sputum revealed birefringent calcium oxalate crystals within histiocytic giant cells (Picture 2A) and a hyaline septate mold (Picture 2B, Grocott staining), although Aspergillus species were not identified on fungal sputum cultures. Thus, pulmonary aspergilloma was diagnosed, and antifungal treatment with oral voriconazole resolved the symptoms and radiological findings. Some Aspergillus species, such as A. niger, produce oxalate, which can form oxalate crystals that become deposited in tissues where they can cause damage and lead to unfavorable outcomes (1).

Picture 1.

Picture 2.

The authors state that they have no Conflict of Interest (COI).