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一名患有鼻咽癌和肝细胞癌患者的头状Magnusiomyces肺结节

Magnusiomyces Capitatus Lung Nodule in a Patient with Nasopharyngeal and Hepatocellular Carcinoma.

作者信息

Lo Shih-Hao, Wang Hsin-Hui, Chang Ya-Ting, Lin Chih-Hung, Lu Po-Liang, Lin Shang-Yi

机构信息

Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Department of Internal Medicine, Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan.

出版信息

Mycopathologia. 2023 Oct;188(5):841-843. doi: 10.1007/s11046-023-00786-2. Epub 2023 Sep 2.

Abstract

Magnusiomyces capitatus is a dimorphic yeast commonly isolated from the environment and was uncommonly reported as a disease in Asia. It may cause invasive infection in patients with hematological malignancies, especially those with neutropenia, and resulting in high mortality. Herein, we reported a man with nasopharyngeal carcinoma and hepatocellular carcinoma suffered from intermittent fever after pulmonary nodules resection. The histopathology showed yeast-like fungal elements. For further identification, we extracted the tissue DNA from formalin-fixed paraffin-embedded tissue and M. capitatus was confirmed using polymerase chain reaction amplification and sequencing of the ITS region of ribosomal DNA. After a 4-week amphotericin B and flucytosine treatment, his condition recovered well and then was followed by a 3-month oral fluconazole treatment. There was no evidence of recurrence within one year. Our case highlights that nucleic acids obtained from formalin-fixed tissue could be a feasible identification method, especially in those whose culture results are unavailable.

摘要

头状大奴霉菌是一种常见于从环境中分离出来的二态性酵母,在亚洲作为一种疾病的报道并不常见。它可能导致血液系统恶性肿瘤患者,尤其是中性粒细胞减少患者发生侵袭性感染,并导致高死亡率。在此,我们报告了一名患有鼻咽癌和肝细胞癌的男性,在肺结节切除术后出现间歇性发热。组织病理学显示有酵母样真菌成分。为了进一步鉴定,我们从福尔马林固定石蜡包埋组织中提取组织DNA,并通过核糖体DNA的ITS区域的聚合酶链反应扩增和测序确认了头状大奴霉菌。经过4周的两性霉素B和氟胞嘧啶治疗后,他的病情恢复良好,随后接受了3个月的口服氟康唑治疗。一年内没有复发的迹象。我们的病例强调,从福尔马林固定组织中获得的核酸可能是一种可行的鉴定方法,尤其是在那些无法获得培养结果的情况下。

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