Article record

早期肺癌患者侵袭性肺曲霉病的罕见临床表现：一例病例报告

Rare clinical presentation of invasive pulmonary aspergillosis in patient with early-stage lung cancer: a case report.

临床研究咽喉科IF 3.7Q1

文献信息

PMID	42813033
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Tatjana Adzić-Vukicevic 查看其他 6 位作者 Sead Dalifi；Katarina Petkovic；Milan Savic；Katarina Lukic；Dragana Sobic-Saranovic；Jon Salmanton-García
作者单位	Faculty of Medicine, University of Belgrade, Belgrade, Serbia. 查看其他 7 条单位信息 Clinic for Pulmonology, University Clinical Center of Serbia, Belgrade, Serbia.；Clinic for Thoracic Surgery, University Clinical Center of Serbia, Belgrade, Serbia.；Center for Radiology and MRI, University Clinical Center of Serbia, Belgrade, Serbia.；Center for Nuclear Medicine with PET, University Clinical Center of Serbia, Belgrade, Serbia.；Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.；Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.；German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
期刊	Frontiers in medicine
SCI 分区	Q1
IF	3.7
研究类型	临床研究 · 临床
所属专科	咽喉科

中文摘要

背景： 侵袭性肺曲霉病（IPA）是一种危及生命的并发症，主要见于严重中性粒细胞减少症患者或接受抗癌治疗后的实体器官癌症患者。本文旨在识别肺癌患者中IPA的临床表现。方法：一名65岁男性，有严重慢性阻塞性肺疾病和既往喉癌病史，因发热入院。五个月前，他因早期鳞状细胞肺癌接受手术。术后病程并发皮下气肿和复发性气胸。重复胸部计算机断层扫描（CT）显示对侧肺叶出现新的空洞性病变，引起对肿瘤复发的担忧。随后的支气管镜检查及支气管吸出物培养检出黑曲霉。分子检测也显示曲霉存在的阳性结果。一线伏立康唑治疗导致显著的临床和影像学改善。伏立康唑治疗6个月后进行的正电子发射断层扫描（PET-CT）显示右肺下叶仅有轻度氟脱氧葡萄糖（FDG）摄取，无其他受累区域。结论：本病例强调了肺癌患者多学科方法的重要性，其中术后影像学变化可能代表肿瘤复发、细菌感染或真菌病。

英文摘要

Invasive pulmonary aspergillosis (IPA) presents life-threatening complication mostly seen in patients with severe neutropenia or in patients with solid organ cancers after applied anticancer therapy. The aim of this manuscript is to identify clinical manifestations of IPA in lung cancer patient. A 65-year-old male with a history of severe chronic obstructive lung disease and prior laryngeal carcinoma was admitted to hospital due to fever. Five months before he was operated because of early-stage squamous cell lung carcinoma. Postoperative course was complicated with subcutaneous emphysema and recurrent pneumothorax. The appearance of new excavated lesions in the contralateral lobes on repeated chest computed tomography (CT) raised concern for tumor recurrence. Subsequent bronchoscopy with bronchoaspirate culture yielded Aspergillus niger. Molecular tests also showed positive findings for Aspergillus presence. First-line treatment with voriconazole resulted in significant clinical and radiological improvement. Positron emission tomography (PET-CT) done 6 months after voriconazole treatment showed only mild fluorodeoxyglucose (FDG) uptake in the right lower lobe, with no other areas of involvement This case highlights the importance of a multidisciplinary approach in lung cancer patients, where post-operative radiologic changes can represent tumor recurrence, bacterial infection or fungal disease.