A Case of Invasive Pulmonary Aspergillosis with Multiple Pulmonary Nodules Diagnosed by Surgery

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  • 手術により診断した肺多発結節を呈した侵襲性肺アスペルギルス症の1例
  • シュジュツ ニ ヨリ シンダン シタ ハイ タハツ ケッセツ オ テイシタ シンシュウセイ ハイ アスペルギルスショウ ノ 1レイ

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Abstract

<p>Pulmonary aspergillosis presents with a variety of pathological and imaging findings due to the interrelationship between the host's immune status and pulmonary structures, and the patient is often in poor general condition due to comorbidities, so the indication for surgery should be carefully determined. We report a case of invasive pulmonary aspergillosis with multiple pulmonary nodules, which was diagnosed by surgery. The patient was a 67-year-old woman. She underwent autologous peripheral blood stem cell transplantation for diffuse large B-cell lymphoma. On day 4 of transplantation, an infiltrative shadow with a cavity appeared in the S8 of the left lung, and multiple pulmonary nodules also appeared on day 15 of transplantation. Bronchoscopy detected Aspergillus in the S8 lesion. A needle biopsy of the multiple pulmonary nodules was performed, but no definitive diagnosis was reached. Antifungal drugs were administered, but the left S8 lesion became lung abscess-like, and a left lung lower lobectomy plus partial upper lobectomy was performed for diagnostic treatment. Pathology showed Aspergillus in lesions other than S8, and the diagnosis of invasive pulmonary aspergillosis was made. One year and 10 months after surgery, the patient is taking antifungal medication and is alive with no worsening of condition.</p>

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