Fulminant pulmonaryAspergillus infection occluding the aortic arch after high-dose antileukemic chemotherapy

Kluin-Nelemans, Hanneke C.; Koelma, I. A.; Merwe, P. C. Der Van; Peetermans, WE

doi:10.1002/1097-0142(19910615)67:12<3123::aid-cncr2820671230>3.0.co;2-5

Cited by 5 publications

(3 citation statements)

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“…The severe chest pain which developed suddenly 17 days before death was most likely due to the invasion of the aortic wall, and the transmural spread from the adventitia to the intima seems to have proceeded rapidly. A similar case was reported by Kluin-Nelemans et al [8]. The large, domeshaped mural thrombus must have caused a severe derangement of blood flow.…”

Section: Discussionsupporting

confidence: 79%

“…They include the formation of a mural thrombus [8], embolic occlusion of the aortic lumen [2,10], aortic aspergilloma [15], mycotic aneurysm [4,11,12] or pseudoaneurysm [3], rupture of the sinus of Valsalva [7], and aspergillus aortitis [6,11,15]. These aortic lesions have been discussed with particular reference to their clinical and hemodynamic aspects, but there are very few detailed descriptions and analysis of histopathological findings.…”

Section: Discussionmentioning

confidence: 99%

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Aortic lesions in aspergillosis: histopathological study of two autopsy cases

et al. 2001

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The involvement of the aorta in aspergillosis is relatively rare, and its histopathological features have not been described in detail. In two autopsy cases of invasive aspergillosis in immunologically compromised patients with hematological disorders, the aspergillotic lesions of the aorta showed different characteristic histopathological features depending on the three layers of aortic wall. Intimal lesions were formations of the mural thrombus composed of aggregates of numerous fungal hyphae arranged perpendicularly to the aortic wall. In the media, smooth muscle cells were completely necrotic (anemic infarct of the media), while the framework of elastic fibers was well preserved, with only a few fungal hyphae detected. In the adventitia, an intense, partly granulomatous chronic inflammatory change with fibrosis was observed in association with mycotic embolic occlusion of the vasa vasorum. These histopathological changes were considered to represent one of the typical tissue reaction patterns in the wall of an elastic artery in aspergillosis.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Aortic lesions in aspergillosis: histopathological study of two autopsy cases

et al. 2001

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“…Aortic infection by Aspergillus has been described in patients with hematologic disorders, including mycotic aneurysm of the thoracic aorta [1] , rupture of a sinus of Valsalva aneurysm [2] , occlusion of the aortic arch [3] , a polypoid mass within the lumen of the descending aorta [4] , and a mycotic sinus of Valsalva pseudoaneurysm [6] . In cases with a mycotic aneurysm of the thoracic aorta, occlusion of the aortic arch, and a polypoid mass within the lumen of the descending aorta, patients had neutropenia and developed pulmonary Aspergillus infection [1] , [3] , and the pulmonary lesions invaded the aorta directly. In cases with a sinus of Valsalva aneurysm or pseudoaneurysm, the preceding disease was Aspergillus endocarditis or Aspergillus pericarditis due to an immunocompromised state [2, 6] .…”

Section: Discussionmentioning

confidence: 99%

Invasive aspergillosis in the aortic arch with infectious Aspergillus lesions in pulmonary bullae

Watanabe

Nakayama

Yamada

et al. 2015

Medical Mycology Case Reports

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A patient with pulmonary bullae died of massive hemoptysis. At autopsy a hole was observed in the aortic wall. A microscopic examination indicated small Aspergillus lesions in pulmonary bullae and extensive necrotic lesions with Aspergillus hyphae in the media of the thoracic aorta. These findings led to a diagnosis of invasive aspergillosis in the aortic arch. This is a rare case in which Aspergillus invaded the aorta in a patient without hematologic neoplasms or neutropenia.

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