Carette M F, Isnard F, Mayaud C, Valade S, Akoun G, Helenon C, Bigot J M
J Radiol. 1986 May;67(5):381-9.
A retrospective study of 18 immunodepressed patients with acute invasive pulmonary aspergillosis enabled the radiologic picture of this increasingly frequent opportunist affection to be described, and different manifestations of the disease as a function of underlying conditions to be determined. Two groups could be distinguished: the first of patients with malignant blood diseases (n = 10) when the "aplasia" factor was dominant; the second of patients without blood diseases (n = 8) when the immunodepression was usually induced by a recent increase in corticoid therapy. Neutropenia was not a finding in any of these patients. The most frequent radiologic finding was single or multiple round excavating foci, these corresponding to zones of bronchopneumonia containing aspergillus filaments with central tissue necrosis forming the "target" lesion. The aplasia was distinguished by the multiplicity of lesions and their excavation following aplasia in the shape of a crescent due to sequestrum formation. Prognosis was related to severity of subjacent lesions. In the 2nd group, lesions could be single and nodular; prognosis was improved by the possibility of reducing immunodepression factors.
对18例免疫抑制的急性侵袭性肺曲霉病患者进行的回顾性研究，使得能够描述这种日益常见的机会性感染的影像学表现，并确定该疾病因基础疾病不同而产生的不同表现。可将患者分为两组：第一组为恶性血液病患者（n = 10），此时“发育不全”因素占主导；第二组为非血液病患者（n = 8），其免疫抑制通常由近期皮质激素治疗增加所致。这些患者均未发现中性粒细胞减少。最常见的影像学表现是单个或多个圆形空洞病灶，这些病灶对应于含有曲霉丝的支气管肺炎区域，中央组织坏死形成“靶”病变。发育不全的特点是病变多发，且由于死骨形成，发育不全后病变呈新月形空洞。预后与潜在病变的严重程度相关。在第二组中，病变可为单个结节状；通过降低免疫抑制因素的可能性，预后有所改善。
