Department Oncology, King Khalid Hospital, Najran, Saudi Arabia.
Department of Internal Medicine, Faculty of Medicine, Hadhramout University, Hadhramout, Yemen.
Pan Afr Med J. 2022 Jun 20;42:135. doi: 10.11604/pamj.2022.42.135.34116. eCollection 2022.
Coexisting primary pulmonary leiomyosarcoma (PPL) with pulmonary Aspergillosis in immunocompetent patients is a rare occurrence. Here, we presented a 54-year-old woman presented with a dry cough for two months. Bronchoscopy revealed pulmonary aspergillosis. The patient was treated with antifungal therapy for one month without improvement. To evaluate further, a chest computed tomography (CT) scan showed a large heterogeneous enhancing mass in the lower lobe of the left lung with left atrium thrombosis. Computed tomography-guided biopsy was performed, and histopathology demonstrated the diagnosis of PPL. The metastasis workup staging showed multiple metastases in vertebrae, scapula, rib, and liver. The patient was treated with chemotherapy followed by tumor bed radiotherapy. Unfortunately, her general condition worsened, and she passed away with overall survival of fourteen months. In conclusion, clinicians should be alert to underlying malignant disease if airway Aspergillus infection is suspicious in patients without strong risk factors for invasive fungal infection.
免疫功能正常患者同时患有原发性肺平滑肌肉瘤（PPL）和肺曲霉病较为罕见。在此，我们报告了 1 例 54 岁女性，因干咳 2 个月就诊。支气管镜检查显示肺曲霉病。患者接受了 1 个月的抗真菌治疗，但无改善。为了进一步评估，胸部计算机断层扫描（CT）显示左肺下叶有一个大的混杂性增强肿块，伴左心房血栓形成。进行了 CT 引导下活检，组织病理学显示 PPL 的诊断。转移灶分期显示脊椎、肩胛骨、肋骨和肝脏多处转移。患者接受了化疗，随后进行了肿瘤床放疗。不幸的是，她的一般情况恶化，总生存期为 14 个月。总之，如果气道曲霉感染在无侵袭性真菌感染强危险因素的患者中被怀疑，临床医生应警惕潜在的恶性疾病。
