Korean J Urol.  2010 Mar;51(3):216-218.

An Aspergilloma Mistaken for a Pelviureteral Stone on Nonenhanced CT: A Fungal Bezoar Causing Ureteral Obstruction

Affiliations
  • 1Department of Urology, Kangwon National University School of Medicine and Clinical Research Institute of Kangwon National University Hospital, Chuncheon, Korea. paulee@kangwon.ac.kr

Abstract

Fungus balls rarely cause upper urinary tract obstruction, and they are most often found in patients with diabetes mellitus or impaired immunity. The computed tomography (CT) findings of fungal bezoars of the urinary tract are nonspecific and have rarely been described, while in most cases, radiolucent filling defects are observed on excretory or retrograde urography. Here, an unusual case of an aspergilloma causing ureteral obstruction is presented; it was initially mistaken for a pelviureteral stone on nonenhanced CT.

Keyword

Aspergillosis; Spiral computed tomography; Ureteral obstruction

MeSH Terms

Aspergillosis
Bezoars
Diabetes Mellitus
Fungi
Humans
Tomography, Spiral Computed
Ureter
Ureteral Obstruction
Urinary Tract
Urography

Figure

  • FIG. 1 Nonenhanced computed tomography (CT) of the abdomen showing the 7 cm dumbbell-shaped lesion (black arrow) with areas of high attenuation in the dilated right renal pelvis and upper ureter. (A) An axial CT image. (B) A coronal CT image.

  • FIG. 2 (A) Gross specimen of the removed fungus ball, which had a putty-like consistency. (B) A histopathological section of the specimen showing fungal hyphae with septation, parallel walls, and branching at acute angles, suggestive of Aspergillus (H&E, ×100).


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