CTICasesMultiple Aspergillomas (Mycetomas) in a Cavitary MAI Infection
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Imaging findings
A chest radiograph showed a cavity in the right upper lobe containing multiple (approximately 5-6) intracavitary, dependent masses. Coronal CT images confirmed the 'Monad sign' with numerous intracavitary masses, consistent with aspergillomas or mycetomas, within a cavity caused by a proven Mycobacterium avium complex (MAI) infection. These masses were noted to be growing over time.
Key takeaways
The 'Monad sign' on radiography or CT, presenting as multiple intracavitary, dependent masses, is highly characteristic of aspergillomas (mycetomas). These fungal balls commonly form within pre-existing lung cavities, such as those caused by MAI infection, and can increase in size over time. Recognizing this classic sign is important for diagnosis and management.
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