RETAINED SPONGE AFTER THORACOTOMY THAT MIMICKED ASPERGILLOMA

A 63-year-old man, who had had operation for the treatment of pulmonar y tuberculosis 40 years before the present disorder, was admitted to o ur hospital with massive hemoptysis. Radiologic examinations showed a mass shadow with a crescent air sign resembling aspergilloma. Operativ e exploration showed a well-encapsulated retained surgical sponge betw een the middle and lower lobes. A bronchial fistula was present in the lower lobe. The appearance of the crescent air sign was caused by dra inage of exudative effusion around the retained sponge. Intrathoracic retained surgical sponges associated with bronchial fistula should be included in the differential diagnosis of patients who have mass shado ws with crescent air signs but no evidence of Aspergillus infection, a nd who have a history of thoracotomy.