Smith F B, Beneck D
St. Vincent's Hospital and Medical Center of New York, New York City 10011.
Chest. 1991 Aug;100(2):554-6. doi: 10.1378/chest.100.2.554.
Saprophytic infestation with Aspergillus was observed in pathologic specimens of primary squamous cell lung carcinoma. In one case, the fungus grew in cystic scarred parenchyma and bronchi distal to an obstructing carcinoma of a segment bronchus. In the other, fungi colonized the inner surface of a peripheral cavitary carcinoma. Neither patient had roentgenographic evidence of aspergilloma and neither experienced severe pulmonary hemorrhage or other complications attributable to the presence of fungus. Although both specimens showed colonizing growth within the abnormal air spaces, in neither had the colonies detached to form a separate intracavitary fungus ball. These patients, and eight patients with similar lesions reported in the literature, demonstrate that Aspergillus colonization of a lung neoplasm frequently lacks one or both of the features characteristic of post-inflammatory intracavitary aspergilloma, a loose fungus ball and antifungal serum antibodies. No patient, to date, has developed massive hemorrhage as a complication of this lesion.
在原发性肺鳞状细胞癌的病理标本中观察到曲霉菌的腐生感染。在1例中，真菌生长于囊性瘢痕化实质以及段支气管阻塞性癌远端的支气管内。在另1例中，真菌定植于周围空洞性癌的内表面。两名患者均无曲霉球的影像学证据，也均未出现因真菌存在导致的严重肺出血或其他并发症。尽管两份标本均显示在异常气腔内有定植性生长，但均未形成分离的腔内真菌球。这些患者以及文献报道的8例具有类似病变的患者表明，肺肿瘤的曲霉菌定植通常缺乏炎症后腔内曲霉球的一个或两个特征，即松散的真菌球和抗真菌血清抗体。迄今为止，尚无患者因该病变出现大出血并发症。
