Document Detail


A clinicopathological study of pulmonary mucormycosis in cancer patients: extensive angioinvasion but limited inflammatory response.
MedLine Citation:
PMID:  19576639     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Pulmonary mucormycosis (PMM) is an emerging, frequently lethal fungal infection in immunosuppressed cancer patients. We sought to characterize the histopathologic features of PMM in this population. METHODS: We identified patients with PMM who underwent autopsy or lung biopsy between 1990 and 2007. Histopathology slides were blindly reviewed by a pathologist and findings were scored on standardized forms. Pathologic findings were correlated with demographic and clinical data abstracted from patient's medical records. RESULTS: Twenty patients with PMM were included in this study. Nineteen patients (95%) had hematologic malignancies. High frequencies of angioinvasion (100%), hemorrhagic infarction (90%), coagulative necrosis (85%), and intra-alveolar hemorrhage (85%) were observed, whereas inflammatory infiltrates were uncommon (30%). Neutropenic patients had more extensive angioinvasion compared with non-neutropenic patients (77% versus 29%, P=0.06). Allogeneic hematopoietic stem cell transplantation (HSCT) recipients, all of whom had graft-versus-host disease, had more inflammatory cell infiltration but less intra-alveolar hemorrhage than non-HSCT patients (67% versus 14%, P=0.04; 50% versus 100%, P=0.02, respectively). CONCLUSIONS: PMM in immunocompromised cancer patients is characterized by extensive angioinvasion and coagulative necrosis. The different histopathologic features of PMM in neutropenic, non-neutropnic, and HSCT patients may reflect differences in the pathobiology of PMM in these populations.
Authors:
Ronen Ben-Ami; Mario Luna; Russell E Lewis; Thomas J Walsh; Dimitrios P Kontoyiannis
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Publication Detail:
Type:  Journal Article     Date:  2009-06-11
Journal Detail:
Title:  The Journal of infection     Volume:  59     ISSN:  1532-2742     ISO Abbreviation:  J. Infect.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-11     Completed Date:  2009-10-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7908424     Medline TA:  J Infect     Country:  England    
Other Details:
Languages:  eng     Pagination:  134-8     Citation Subset:  IM    
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Female
Histocytochemistry / methods
Humans
Immunocompromised Host
Inflammation / pathology
Lung Diseases, Fungal / pathology*,  physiopathology*
Male
Middle Aged
Mucormycosis / pathology*,  physiopathology*
Necrosis / pathology
Neoplasms / complications*
Severity of Illness Index
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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