Abstract: Objective To investigate the imaging findings of non-active pulmonary tuberculosis complicated by pulmonary fungal infection, and to provide evidence for its early diagnosis. Methods A total of 20 cases were collected based on the recruitment criteria, including 14 males and 6 females. Their clinical imaging data were retrospectively analyzed. Results The history of pulmonary tuberculosis ranged from 9 months to 31 years, with a mean of 10.6 years. The presenting symptoms included cough, expectoration and hemoptysis. As for pulmonary aspergillosis, 13 cases were diagnosed with aspergilloma; 4 cases with chronic necrotizing pulmonary aspergillosis; 2 cases with chronic cavitary aspergillosis and 1 case with chronic fibrosis of pulmonary aspergillosis. The lesions of pulmonary aspergillosis were commonly located at the apicoposterior segment of the upper lobes of both lungs, dorsal segment of the lower lobes of both lungs, which were consistent with that of pulmonary tuberculosis. The imaging demonstrations included singular or multiple heterogenous mass opacity, cavitary opacity, and air crescent opacity. Meanwhile, fibrous cords like opacity of old tuberculosis lesions were demonstrated in the lungs. Conclusion As for inactive pulmonary tuberculosis complicated by pulmonary aspergillosis, 60% of the cases are definitely diagnosed at 4 years after tuberculosis infection. Aspergilloma is the most common pulmonary aspergillosis complicating inactive pulmonary tuberculosis. CT scan demonstrations include heterogenous mass opacity and air crescent opacity at upper lobes of both lungs, occasionally accompanied by fibrous cords like opacity of old tuberculosis lesions.

Key words: Pulmonary tuberculosis, Pulmonary aspergillosis, CT