Male, 45 years old, quarry worker for 15 years. Diagnosed with complicated silicosis in FMP. Ex-smoker for two years, 25 packs/year. Pulmonary tuberculosis in 2007. He attended the Emergency Department in March 2009 with threatening haemoptysis, preceded by cough and brownish expectoration of 4 weeks of evolution. Physical examination showed normal vital signs and bilateral rhonchi on pulmonary auscultation. Serum tests showed leukocytosis (11,280 cells/μl with 80% neutrophils) with no other abnormalities. Fibrobronchoscopy revealed a large clot in the right upper lobe bronchus. CT showed bilateral and diffuse micronodular interstitial involvement, some calcified nodules, predominantly in the upper lobes and conglomerates that had increased with respect to previous studies, with the appearance of material inside them, as well as nodular and diffuse pleural thickening. Culture was positive for Aspergillus fumigatus in sputum and bronchial aspirate. Blood IgG precipitins were positive and galactomannan antigen negative. Embolisation of the bronchial arteries of the LSI was performed with control of haemoptysis and treatment with voriconazole was started with good evolution after one year of treatment with negative serum precipitins.