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A Case of Invasive Pulmonary Aspergillosis with Direct Invasion of the Mediastinum and the Left Atrium in an Immunocompetent Patient

결핵및호흡기질환 2014년 77권 1호 p.28 ~ p.33

한규현(Han Kyu-Hyun) - CHA University CHA Bundang Medical Center Department of Internal Medicine
김정현(Kim Jung-Hyun) - CHA University CHA Bundang Medical Center Department of Internal Medicine
신순영(Shin Sun-Young) - CHA University CHA Bundang Medical Center Department of Internal Medicine
정혜윤(Jeong Hye-Yun) - CHA University CHA Bundang Medical Center Department of Internal Medicine
추지민(Chu Ji-Min) - CHA University CHA Bundang Medical Center Department of Internal Medicine
김학수(Kim Hak-Su) - CHA University CHA Bundang Medical Center Department of Internal Medicine
김대진(Kim Dae-Jin) - CHA University CHA Bundang Medical Center Department of Internal Medicine
심민정(Shim Min-Jung) - CHA University CHA Bundang Medical Center Department of Internal Medicine
조상호(Cho Sang-Ho) - CHA University CHA Bundang Medical Center Department of Pathology
김은경(Kim Eun-Kyung) - CHA University CHA Bundang Medical Center Department of Internal Medicine

Abstract

We report a case of invasive pulmonary aspergillosis invading the mediastinum and the left atrium. A 70-year-old woman was hospitalized for dyspnea. She had been well controlled for her diabetes mellitus and hypertension. The chest X-ray disclosed mediastinal widening, and the computed tomography scan of the chest showed that there was a large mediastinal mass and this lesion extended into the left atrium and right bronchus. The cardiac echocardiography showed that a huge mediastinal cystic mass compressed in the right atrium and a hyperechoic polypoid lesion in the left. The pathology from the bronchoscopic biopsy observed abundant fungal hyphae which was stained with periodic acid-Schiff and Gomori’s methenamine silver. Despite the treatment with antifungal agents, she died from cardiac tamponade after three months. Invasive pulmonary aspergillosis, which involves the mediastinum and the heart, is very rare in immunocompetent patients.

키워드

Invasive Pulmonary Aspergillosis, Immunocompetence, Mediastinal Neoplasms, Heart Neoplasms

KMID : 0383820140770010028

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DOI

KCD코드

ICD 03

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