OBJECTIVES: Pulmonary mucormycosis (PMM) is an emerging, frequently lethal fungal infection in immunosuppressed cancer patients. We sought to characterize the histopathologic features of PMM in this population. METHODS: We identified patients with PMM who underwent autopsy or lung biopsy between 1990 and 2007. Histopathology slides were blindly reviewed by a pathologist and findings were scored on standardized forms. Pathologic findings were correlated with demographic and clinical data abstracted from patient's medical records. RESULTS: Twenty patients with PMM were included in this study. Nineteen patients (95%) had hematologic malignancies. High frequencies of angioinvasion (100%), hemorrhagic infarction (90%), coagulative necrosis (85%), and intra-alveolar hemorrhage (85%) were observed, whereas inflammatory infiltrates were uncommon (30%). Neutropenic patients had more extensive angioinvasion compared with non-neutropenic patients (77% versus 29%, P=0.06). Allogeneic hematopoietic stem cell transplantation (HSCT) recipients, all of whom had graft-versus-host disease, had more inflammatory cell infiltration but less intra-alveolar hemorrhage than non-HSCT patients (67% versus 14%, P=0.04; 50% versus 100%, P=0.02, respectively). CONCLUSIONS: PMM in immunocompromised cancer patients is characterized by extensive angioinvasion and coagulative necrosis. The different histopathologic features of PMM in neutropenic, non-neutropnic, and HSCT patients may reflect differences in the pathobiology of PMM in these populations.
OBJECTIVES:Pulmonary mucormycosis (PMM) is an emerging, frequently lethal fungal infection in immunosuppressed cancerpatients. We sought to characterize the histopathologic features of PMM in this population. METHODS: We identified patients with PMM who underwent autopsy or lung biopsy between 1990 and 2007. Histopathology slides were blindly reviewed by a pathologist and findings were scored on standardized forms. Pathologic findings were correlated with demographic and clinical data abstracted from patient's medical records. RESULTS: Twenty patients with PMM were included in this study. Nineteen patients (95%) had hematologic malignancies. High frequencies of angioinvasion (100%), hemorrhagic infarction (90%), coagulative necrosis (85%), and intra-alveolar hemorrhage (85%) were observed, whereas inflammatory infiltrates were uncommon (30%). Neutropenicpatients had more extensive angioinvasion compared with non-neutropenicpatients (77% versus 29%, P=0.06). Allogeneic hematopoietic stem cell transplantation (HSCT) recipients, all of whom had graft-versus-host disease, had more inflammatory cell infiltration but less intra-alveolar hemorrhage than non-HSCT patients (67% versus 14%, P=0.04; 50% versus 100%, P=0.02, respectively). CONCLUSIONS:PMM in immunocompromised cancerpatients is characterized by extensive angioinvasion and coagulative necrosis. The different histopathologic features of PMM in neutropenic, non-neutropnic, and HSCT patients may reflect differences in the pathobiology of PMM in these populations.
Authors: Theodouli Stergiopoulou; Joseph Meletiadis; Emmanuel Roilides; David E Kleiner; R Schaufele; Maureen Roden; Susan Harrington; Luqman Dad; Brahm Segal; Thomas J Walsh Journal: Am J Clin Pathol Date: 2007-03 Impact factor: 2.493
Authors: Maureen M Roden; Theoklis E Zaoutis; Wendy L Buchanan; Tena A Knudsen; Tatyana A Sarkisova; Robert L Schaufele; Michael Sein; Tin Sein; Christine C Chiou; Jaclyn H Chu; Dimitrios P Kontoyiannis; Thomas J Walsh Journal: Clin Infect Dis Date: 2005-07-29 Impact factor: 9.079
Authors: Aasma Shaukat; Faris Bakri; Paul Young; Theresa Hahn; Donna Ball; Maria R Baer; Meir Wetzler; James L Slack; Peter Loud; Myron Czuczman; Philip L McCarthy; Thomas J Walsh; Brahm H Segal Journal: Mycopathologia Date: 2005-02 Impact factor: 2.574