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Finding Sources
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I now have everything I need. Let me give a clear, simple breakdown of this radiology report.
What This Report Says - Simply Explained
This is a CT scan report of the chest (HRCT = High Resolution CT) for Sultana Begum, 60 years old, done on 30 June 2026 at CMH Kohat.
The Findings, One by One
1. "Fibrobronchiectatic changes in bilateral upper lobes"
Think of the lungs like a tree. The upper branches (airways) in both lungs are scarred, widened, and damaged. This is called bronchiectasis - the airways are permanently stretched and thickened from old infection. "Fibro-" means there is also fibrous (scar) tissue around them.
This is a classic result of old tuberculosis (TB) that happened in the past.
2. "A cavitary lesion in the right upper lobe measuring 2.3 x 3.8 x 3.3 cm"
A cavity is a hollow space (like a small cave) inside the lung. This one is roughly 3 cm wide - about the size of a large grape. It was most likely formed by old TB destroying that part of the lung tissue.
3. "Intracavitary soft tissue density mass, separated from the cavity wall by a surrounding crescent of air - Air Crescent Sign"
This is the most important finding. Inside that hollow cave in the lung, a ball of fungus has grown. Picture this:
- The cavity is the "cave"
- The fungus ball sits inside it like a ball sitting in a bowl
- Around the top of the ball, there is a thin crescent (half-moon) of air between the ball and the cave wall
This "air crescent sign" is the classic, textbook CT finding of a fungus ball (mycetoma/aspergilloma). The handwritten note "halo sign" on your report also refers to a similar radiological sign seen with fungal infections.
4. "Both hila are normal, no lymphadenopathy, no pleural/pericardial effusion"
- No swollen lymph nodes in the center of the chest
- No fluid around the lung or heart
- All major structures (heart, windpipe, food pipe, blood vessels) are normal
These are reassuring negative findings - the disease is localised, not spreading.
The Opinion (Diagnosis)
"Post infective changes in bilateral upper lobes with mycetoma formation in the right upper lobe"
In plain language:
- Both upper lobes show scars from an old infection (almost certainly old TB)
- Inside one of those old scars/cavities, a fungus (Aspergillus) has moved in and grown into a ball - this is called a mycetoma or aspergilloma (also called a "fungus ball")
What is a Mycetoma/Aspergilloma?
| Feature | Simple Explanation |
|---|---|
| What it is | A ball of fungus (usually Aspergillus) growing in an old lung cavity |
| How it forms | Old TB destroys lung tissue, leaving a hollow cavity. Fungus spores breathed in can settle and grow there |
| Main risk | Serious coughing up of blood (hemoptysis) - sometimes life-threatening |
| Is it spreading? | No - it is NOT active TB, and NOT lung cancer. It is a fungus sitting in an old scar |
| Common in | Countries with high TB prevalence (South Asia, Africa) - over 90% of aspergillomas in developing countries are due to old TB cavities (Fishman's Pulmonary Diseases, p. 2329) |
What Should Be Done Next?
This report says "clinical correlation is requested" - meaning the treating doctor needs to combine this CT result with the patient's symptoms and blood tests. Typical next steps include:
- Sputum culture / fungal tests (Aspergillus serology - precipitins, IgG)
- Pulmonologist referral for management
- Antifungal treatment (e.g., itraconazole) for symptomatic cases
- Surgical removal may be considered if there is repeated heavy bleeding
- Watch and monitor if no symptoms (some fungus balls can even shrink on their own)
Bottom Line: The patient's lungs show scars from old lung infection (TB), and a fungus ball (mycetoma) has grown inside one of those old scars. It is NOT active TB, NOT cancer - but it does need proper medical follow-up because fungus balls can cause significant bleeding.
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