Inflammatory pseudotumor of the lung following invasive aspergillosis in a patient with chronic graft-vs.-host disease.
Inflammatory myofibroblastic tumor (IMT) is an uncommon cause of solitary or multifocal lung nodules and can also be rarely found in various other extrapulmonary sites. Although this pseudotumor is benign, it can be locally very aggressive. The pathogenesis of IMT remains unclear; autoimmune or infectious origins have been hypothesized, so far. Here, we report a case of inflammatory pseudotumor of the lung secondary to invasive pulmonary aspergillosis in a patient with chronic graft-vs.-host disease. The 42-year-old patient presented with coughing and hemoptysis as major clinical signs 1 yr after successful HLA-identical stem cell transplantation. Aspergillus fumigatus was cultured from the bronchoscopic lavage, but intensive antifungal treatment could only initially improve the clinical situation. Diagnostic re-evaluation by open-chest biopsy surprisingly revealed an inflammatory pseudotumor responsible for clinical and radiographical deterioration. Both clinical and radiographical signs resolved under long-term steroids and secondary antifungal prophylaxis.
Priebe-Richter
Constanze
C
Department of Hematology, Hemostaseology and Oncology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30623 Hannover, Germany.
Ivanyi
Philipp
P
Buer
Jan
J
Länger
Florian
F
Lotz
Joachim
J
Hertenstein
Bernd
B
Ganser
Arnold
A
Franzke
Anke
A
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000517:prevention & control; D006086:Graft vs Host Disease / Q000150:complications; D006801:Humans; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging / Q000473:pathology* / Q000517:prevention & control; D008297:Male; D016726:Plasma Cell Granuloma, Pulmonary / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D033581:Stem Cell Transplantation; D013256:Steroids / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D000935:Antifungal Agents; D013256:Steroids