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F-FDG-PET/CT检查发现的侵袭性甲状腺曲霉菌病罕见病例

A Rare Case of Invasive Thyroid Aspergillosis Revealed on F-FDG-PET/CT.

作者信息

Jaafari Ayoub, Mansour Sohaïb, Lebrun Laetitia, Kaefer Keitiane, Attou Rachid

机构信息

Nuclear Medicine Department, H.U.B Hospital, 1070 Brussel, Belgium.

Internal Medicine Department, C.H.U Brugmann, 1020 Brussel, Belgium.

出版信息

Diagnostics (Basel). 2024 Jul 8;14(13):1451. doi: 10.3390/diagnostics14131451.

Abstract

Invasive aspergillosis (IA) represents a common form of fungal infection caused by various species of that most frequently affect immunocompromised patients. Typically, this disease occurs preferentially in high-risk groups including patients infected with the human immunodeficiency virus (HIV), patients with leukemia, patients with autoimmune diseases, and organ transplant patients undergoing medical immunosuppression. Considered the second most common cause of opportunistic fungal infection in humans after , this pathogen predominantly affects the lungs, but it may also spread by a hematogenous route to various organs and have a heterogeneous presentation. Owing to its high iodine levels, high perfusion, and enclosed capsule, the thyroid gland is considered to have a lower susceptibility to microbial invasion, and it is fairly uncommon to find associated infectious nodules. In metabolic imaging, F-FDG-PET/CT has become increasingly useful for detecting a wide range of infectious and inflammatory diseases and is already the gold standard for certain indications. According to the literature, no studies of hypermetabolic nodular thyroid aspergillosis on F-FDG-PET/CT confirmed on histology have yet been reported. Here, we report the first case of a patient with a heterogeneous presentation of IA and the presence of a hypermetabolic nodule in the thyroid with a surprising result.

摘要

侵袭性曲霉病(IA)是由多种曲霉菌引起的一种常见真菌感染形式,最常影响免疫功能低下的患者。通常,这种疾病优先发生在高危人群中,包括感染人类免疫缺陷病毒(HIV)的患者、白血病患者、自身免疫性疾病患者以及接受医学免疫抑制的器官移植患者。该病原体被认为是人类机会性真菌感染的第二大常见原因,主要影响肺部,但也可能通过血行途径扩散到各个器官,并呈现出异质性表现。由于甲状腺含碘量高、血流灌注丰富且有包膜包裹,被认为对微生物入侵的易感性较低,发现相关感染性结节相当罕见。在代谢成像中,F-FDG-PET/CT在检测多种感染性和炎症性疾病方面越来越有用,并且已经成为某些适应症的金标准。据文献报道,尚未有关于经组织学证实的F-FDG-PET/CT上高代谢结节性甲状腺曲霉病的研究报告。在此,我们报告首例IA表现异质性且甲状腺存在高代谢结节的患者,结果令人惊讶。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e81b/11240972/99c871db8d9a/diagnostics-14-01451-g001.jpg

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