Afolayan Oluwatobi, Copeland Hannah, Zaheer Salman, Wallen Jason M
Department of Surgery, University of Washington, Seattle, Washington.
Department of Surgery, Division of Cardiothoracic Surgery, McGuire VA Medical Center, Richmond, Virginia.
Ann Thorac Surg. 2017 Jun;103(6):e531-e533. doi: 10.1016/j.athoracsur.2017.01.102.
A 57 year old man was referred from an outside facility for an unresolving pneumonia. Imaging of the chest demonstrated a right lung mass with a consolidation in the middle lobe, pleural effusion, and mediastinal lymphadenopathy. Cytologic examination of cultures from the bronchoscopy and thoracentesis did not yield a definitive diagnosis. Video-assisted thoracoscopic surgery (VATS) was performed because of a retained hemothorax and a suggestive lesion. Biopsy specimens obtained during VATS were consistent with mucormycosis. The patient underwent a middle lobectomy and pleurectomy without any adverse event. When bronchoscopy and thoracentesis cannot provide a diagnosis, thoracoscopic pleural biopsy can be the next step in the diagnosis of mucormycosis.
一名57岁男性因肺炎迁延不愈被从外部医疗机构转诊而来。胸部影像学检查显示右肺有一肿块，中叶实变，伴有胸腔积液和纵隔淋巴结肿大。支气管镜检查和胸腔穿刺术培养物的细胞学检查未能得出明确诊断。由于存在胸腔积血和可疑病变，遂进行了电视辅助胸腔镜手术（VATS）。VATS期间获取的活检标本与毛霉菌病相符。患者接受了中叶切除术和胸膜切除术，未发生任何不良事件。当支气管镜检查和胸腔穿刺术无法提供诊断时，胸腔镜胸膜活检可作为毛霉菌病诊断的下一步措施。
