|Pathophysiological implication of reversed CT halo sign in invasive pulmonary mucormycosis: a rare case report|
|Okubo, Yoichiro1; Ishiwatari, Takao1; Izumi, Haruka2; Sato, Fumitomo3; Aki, Kyoko1; Sasai, Daisuke1; Ando, Tsunehiro4; Shinozaki, Minoru1; Natori, Kazuhiko2; Tochigi, Naobumi1; Wakayama, Megumi1; Hata, Yoshinobu3; Nakayama, Haruo5; Nemoto, Tetsuo1; Shibuya, Kazutoshi1,6|
|关键词||Reversed halo sign Mucormycosis Aspergillosis Discrete nodule|
|WOS标题词||Science & Technology|
Background: It has been accepted that reversed halo sign (RHS) appeared on a computed tomography (CT) image in immunocompromised patients indicates an invasive fungal infection, but its pathophysiology remains obscure as to what this image implies. Therefore, the present report describes detailed radiological and histopathological findings of a case of invasive pulmonary mucormycosis (IPM) presenting RHS with comparison to those from a lesion of discrete nodule caused by invasive pulmonary aspergillosis (IPA), and discusses the pathophysiological implications of this characteristic image.
Case presentation: RHS had been clinically noted at the time of recovering of bone marrow function of a 64-year-old Japanese man who had chemotherapy for his acute lymphoblastic leukemia. Histological examination of the surgically removed lung revealed a lesion of IPM. This was composed of coagulation necrosis of septa at the center of lesion with preservation of air content which was encompassed outer rim comprising triplet structure; liquefaction, consolidation, and organization from the inner to the outer layer. In addition, Micro-CT examination confirmed reticular structure and monotonous high density at the central coagulation necrosis preserving air content and surrounding consolidation, and organization lesion of the IPM lesion.
Conclusion: Our investigations suggest that RHS might be understood as a kind of immune reconstitution syndrome and be the initial and prior status of air crescent sign.
|项目编号||H22-Shinkou-Ippan-8 ; H23-Shinkou-Ippan-018 ; 24790364 ; 23-19 ; 23-21 ; 23-28 ; 24-11 ; 24-16 ; 24-27 ; 24-28|
|资助机构||Janssen Pharmaceutical K. K. ; Dainippon Sumitomo Pharma Co. ; Astellas Pharma Inc. ; Taiho Pharmaceutical Co. ; POLA-Pharma Inc. ; Ministry of Health, Labor and Welfare of Japan ; Strategic Basis on Research Grounds for Non-governmental Schools at Heisei 20th ; Strategic Research Foundation Grant-aided Project for Private schools at Heisei 23rd ; KAKENHI ; Ministry of Education, Culture, Sports, Science, and Technology of Japan ; Toho University ; Yokohama Foundation for Advancement of Medical Science ; Toho University Medical School|
|作者单位||1.Toho Univ, Sch Med, Dept Surg Pathol, Ota Ku, Tokyo 1438541, Japan|
2.Toho Univ, Med Ctr, Dept Med, Div Hematol & Oncol,Ota Ku, Tokyo 1438541, Japan
3.Toho Univ, Med Ctr, Dept Chest Surg, Ota Ku, Tokyo 1438541, Japan
4.Japanese Red Cross Med Ctr, Dept Resp Med, Shibuya Ku, Tokyo 1508935, Japan
5.Toho Univ, Ohashi Med Ctr, Dept Neurosurg, Meguro Ku, Tokyo 1538515, Japan
6.Peking Univ, Dept Dermatol, Hosp 1, Beijing 100871, Peoples R China
|Okubo, Yoichiro,Ishiwatari, Takao,Izumi, Haruka,et al. Pathophysiological implication of reversed CT halo sign in invasive pulmonary mucormycosis: a rare case report[J]. DIAGNOSTIC PATHOLOGY,2013,8.|
|APA||Okubo, Yoichiro.,Ishiwatari, Takao.,Izumi, Haruka.,Sato, Fumitomo.,Aki, Kyoko.,...&Shibuya, Kazutoshi.(2013).Pathophysiological implication of reversed CT halo sign in invasive pulmonary mucormycosis: a rare case report.DIAGNOSTIC PATHOLOGY,8.|
|MLA||Okubo, Yoichiro,et al."Pathophysiological implication of reversed CT halo sign in invasive pulmonary mucormycosis: a rare case report".DIAGNOSTIC PATHOLOGY 8(2013).|