title: Invasive tracheobronchial aspergillosis in a patient with systemic lupus erythematosus-dermatomyositis overlap syndrome.
abstract: A 45-year-old man was referred to our hospital with a 3-month history of dyspnea, polyarthralgia, myalgia and weight loss. He was diagnosed with systemic lupus erythematosus/dermatomyositis overlap syndrome with lung involvement, which presented as organizing pneumonia. However, a bronchoscopic examination revealed the presence of multiple plaque-like white lesions with ulcers on the bronchial membrane, located mainly in the central airway. The pathological specimens obtained from bronchoscopy showed numerous filamentous fungal hyphae that were aggressively invading the bronchial walls, suggesting a diagnosis of invasive tracheobronchial aspergillosis. The present case, along with a review of the literature, demonstrates that invasive tracheobronchial aspergillosis can occur in patients who do not appear to be immunosuppressed. This case of aspergillosis should thus be recognized as an extremely rare presentation of an Aspergillus infection.
authors.affiliation: Department of Respiratory Medicine, Kyorin University School of Medicine, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Sada
authors.forename: Takeshi
authors.initials: T
authors.lastname: Saraya
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Shinji
authors.initials: S
authors.lastname: Sato
authors.forename: Megumi
authors.initials: M
authors.lastname: Wakayama
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Shibuya
authors.forename: Takashi
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Hideo
authors.initials: H
authors.lastname: Ogata
authors.forename: Hajime
authors.initials: H
authors.lastname: Takizawa
authors.forename: Hajime
authors.initials: H
authors.lastname: Goto
mesh_terms: D001999:Bronchoscopy; D003882:Dermatomyositis / Q000150:complications*; D006801:Humans; D007121:Immunocompetence; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D055732:Pulmonary Aspergillosis / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D013577:Syndrome; D014133:Tracheal Diseases / Q000150:complications / Q000175:diagnosis / Q000276:immunology