title: Sequential morphological changes in follow-up CT of pulmonary mucormycosis.
abstract: OBJECTIVE
  We aimed to describe the computed tomography (CT) features of pulmonary mucormycosis including sequential changes between follow-ups.
  
  
  METHODS
  Between June 2001 and May 2011, five patients (three males and two females; median age, 43 years; age range, 13-73 years) who had been pathologically diagnosed with pulmonary mucormycosis constituted our study population. Their clinical and CT features including sequential changes over follow-ups were evaluated retrospectively.
  
  
  RESULTS
  All patients were immunocompromised due to either hematologic diseases (n=3), diabetes mellitus (n=1), or steroid administration for autoimmune hepatitis (n=1). All patients had symptoms such as fever (n=5), tachycardia (n=1), or pleuritic chest pain (n=1) on admission. Regarding the clinical outcome after treatment, one patient died, and the remaining four recovered from the disease. In terms of initial CT features, the morphologies of pulmonary mucormycosis included a single mass (n=3), consolidation (n=1), or multiple masses (n=1). There were seven pulmonary lesions in total, 3-7 cm in size, which showed a CT halo sign (n=3), reversed-halo sign (n=2), or air-fluid levels (n=2). On follow-up CTs, the lesions of all patients contained necrosis. All three patients with a mass or masses with a CT halo sign on initial CT had a decreased surrounding halo followed by central necrosis, and the lesions gradually decreased in size on recovery.
  
  
  CONCLUSIONS
  Pulmonary mucormycosis usually manifests as a mass or masses with a halo or reversed-halo sign on the initial CT scan followed by a decreased extent of surrounding ground-glass opacities with the development of internal necrosis during follow-up.
authors.affiliation: From the Department of Radiology (J.Y.C., C.M.P. e-mail: cmpark@radiol.snu.ac.kr, H.J.L., C.H.L., J.M.G. J.G.I.) Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea; the Department of Radiology (J.Y.C.), Korea University Ansan Hospital, Ansan, Korea.
authors.forename: Ji Yung
authors.initials: JY
authors.lastname: Choo
authors.forename: Chang Min
authors.initials: CM
authors.lastname: Park
authors.forename: Hyun-Ju
authors.initials: HJ
authors.lastname: Lee
authors.forename: Chang Hyun
authors.initials: CH
authors.lastname: Lee
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Goo
authors.forename: Jung-Gi
authors.initials: JG
authors.lastname: Im
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000000981:diagnostic imaging* / Q000628:therapy; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
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