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Page 4 / Case 10.03

ANSWER

1. Hypo dense mass located in superior segment of the right lower lobe measuring 3.5 centimeters in diameter.

2. Mass containing some linear lucencies within and surrounding it

3. The "Halo" sign finding was very suggestive of Invasive Pulmonary Aspergillosis. On

June 26th she had trans-thoracic lung biopsy.

On June 27th in the ICU a pneumothorax was treated conservatively.
Below you can see the histo-pathology. The Grocott stain (1) shows the presence of branching septated hyphae. The hyphae are consistent with Aspergillus with no evidence of malignancy.

ENLARGE this Grocott stain

ENLARGE this Aspergillus stain

(1) Her anti-fungal therapy was changed at this time to voriconazol. On July 9th, despite clinical improvement, she remained neutropenic and below is her repeat Chest CT.

ENLARGE this CT image.
ENLARGE this CT image.

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