title: [A case of pulmonary aspergillosis presenting the pulmonary arterial supply suggested with dynamic MRI].
abstract: A 67-year-old man with a past history of pulmonary tuberculosis had been referred to our department complaining of bloody sputum. The chest radiograph on admission showed a cavity in the left upper lung field. Chest CT showed a mass-like fungus ball in the cavity. Pulmonary aspergillosis was diagnosed from the sputum mycology, serum Aspergillus antigen and antibody. Even though 150 mg per day Funguard (micafungin sodium) was given intravenously for 4 weeks, the pulmonary aspergillosis did not improve. Dynamic MRI obtained 20 seconds after intravenous injection of contrast material revealed penetrating vessels in the wall of the cavity, and dilated and proliferative vessels surrounding the cavitary lesion. On the basis of the MRI findings which suggested the risk of massive hemoptysis, we performed left upper lobectomy. The histological specimen revealed dilated pulmonary arteries in the wall of the cavity, corresponding to the penetrating vessels on MRI. This is the first report of radiologic-pathologic correlation using dynamic MRI for pulmonary aspergillosis, to the best of our knowledge.
authors.affiliation: Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University School of Medicine.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Shimizu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takeda
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Tai
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Tozaki
authors.forename: Tomokiyo
authors.initials: T
authors.lastname: Nomura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Fujii
authors.forename: Akira
authors.initials: A
authors.lastname: Hebisawa
mesh_terms: D000368:Aged; D001228:Aspergillosis / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male