Li Li-li, Liu Hong-gang, Piao Ying-shi, He Chun-yan, Zhou Quan, Zhang Yang
Department of Pathology, Beijing Tongren Hospital, Capital Medical University, China.
Zhonghua Bing Li Xue Za Zhi. 2010 Aug;39(8):508-12.
To study the clinicopathologic features of malignant tumors in head and neck region complicated by fungal infection.
Twenty-one cases of malignant tumors occurring in head and neck region complicated by fungal infection were retrieved from the archival file. The light microscopic findings were reviewed. Histochemical (for PAS and GMS) and immunohistochemical (for MUC5B) studies were carried out. Fungal culture results were available in 13 of the 21 cases.
The age of the patients ranged from 12 to 72 years (median = 48 years). The male-to-female ratio was 17:4. Eight cases (38.1%) were complicated by invasive fungal sinusitis, with orbital involvement in 6 cases and brain involvement in 1 case. The primary tumors in such cases included leukemia (n = 7) and nasopharyngeal carcinoma (n = 1). The fungi belonged to Zygomycete in 5 cases and Aspergillus in 3 cases. These patients had history of chemotherapy/radiotherapy or antibiotics usage. The remaining 13 cases of fungal infection often affected necrotic tumor tissue in nasal cavity, paranasal sinuses, pharynx, larynx and palate. The fungi involved were Aspergillus (n = 6) and Candida (n = 4). Seven of such patients had received radiotherapy. Fungal culture was positive in 9 cases. Fourteen patients had follow-up information available and six of them died of the disease.
Malignant tumors occurring in head and neck region can be complicated by fungal infection. Invasive fungal sinusitis (due to Zygomycetes and Aspergillus) often occurs in patients with leukemia, tends to involve orbit and is associated with poor prognosis. On the other hand, Aspergillus and Candida are the commonest fungi found in the necrotic tumor tissue. Pathologic examination remains the hallmark in confirming the diagnosis and fungal typing.
研究头颈部恶性肿瘤合并真菌感染的临床病理特征。
从存档文件中检索出21例头颈部发生恶性肿瘤并合并真菌感染的病例。回顾其光镜检查结果。进行了组织化学（过碘酸雪夫染色和吉姆萨染色）及免疫组织化学（黏蛋白5B）研究。21例中有13例有真菌培养结果。
患者年龄为12至72岁（中位数 = 48岁）。男女比例为17:4。8例（38.1%）合并侵袭性真菌性鼻窦炎，其中6例累及眼眶，1例累及脑。这些病例的原发肿瘤包括白血病（n = 7）和鼻咽癌（n = 1）。5例真菌属于接合菌纲，3例属于曲霉菌。这些患者有化疗/放疗或使用抗生素史。其余13例真菌感染常累及鼻腔、鼻窦、咽、喉及腭部的坏死肿瘤组织。所涉及的真菌为曲霉菌（n = 6）和念珠菌（n = 4）。其中7例患者接受过放疗。9例真菌培养呈阳性。14例患者有随访信息，其中6例死于该病。
头颈部发生的恶性肿瘤可合并真菌感染。侵袭性真菌性鼻窦炎（由接合菌纲和曲霉菌引起）常发生于白血病患者，易累及眼眶，且预后不良。另一方面，曲霉菌和念珠菌是坏死肿瘤组织中最常见的真菌。病理检查仍是确诊及真菌分型的关键。
