Alessio Casutt1, Jade Couchepin2, Anne-Sophie Brunel2, Alban Lovis1, Pierre-Yves Bochud2, Nathalie Keller3, Frédéric Lamoth2,4, Catherine Beigelman-Aubry3. 1. ¹Division of Pulmonology, University Hospital of Lausanne, CHUV, Switzerland. 2. Division of Infectious Diseases, University Hospital of Lausanne, CHUV, Switzerland. 3. Division of Radiology, Department of interventional and diagnostic radiology, University Hospital of Lausanne, CHUV, Switzerland. 4. Institute of Microbiology, University Hospital of Lausanne, CHUV, Switzerland.
Abstract
OBJECTIVE: The aim of this study is to characterize chest CT findings of neutropenic patients with proven/probable invasive pulmonary aspergillosis (IPA). METHODS: Hematological cancer patients admitted to our institution (2007-2017) were retrospectively enrolled if the diagnostic criteria of proven/probable IPA during the neutropenia were met (EORTC/MSG). Galactomannan (GM) was routinely measured in serum and chest CT-scan was routinely performed in case of recurrent/persistent fever. Bronchoscopy was performed in case of chest CT-scan abnormalities. Chest CT-scan and GM dosage were analyzed at the time of IPA suspicion. Chest lesions were classified using a clinical report form by two expert radiologists. RESULTS: 35 patients were identified. Peribronchial focal lesions were observed in 29 IPA (82.9%) by the first radiologist and in 31 (88.5%) by the second (k = 0.768). 12 weeks mortality was 20%. CONCLUSION: Peribronchial focal lesions are a common finding in early-IPA whatever the GM value during neutropenia and our findings reinforce the efficiency of a preemptive approach. ADVANCES IN KNOWLEDGE;: Peribronchial focal lesions, which are classically described in airway invasive aspergillosis, are a common finding in early-IPA in hematological cancer patients with prolonged neutropenia regardless of the GM value, and such peribronchial lesions should reinforce the possibility of IPA.
OBJECTIVE: The aim of this study is to characterize chest CT findings of neutropenic patients with proven/probable invasive pulmonary aspergillosis (IPA). METHODS: Hematological cancer patients admitted to our institution (2007-2017) were retrospectively enrolled if the diagnostic criteria of proven/probable IPA during the neutropenia were met (EORTC/MSG). Galactomannan (GM) was routinely measured in serum and chest CT-scan was routinely performed in case of recurrent/persistent fever. Bronchoscopy was performed in case of chest CT-scan abnormalities. Chest CT-scan and GM dosage were analyzed at the time of IPA suspicion. Chest lesions were classified using a clinical report form by two expert radiologists. RESULTS: 35 patients were identified. Peribronchial focal lesions were observed in 29 IPA (82.9%) by the first radiologist and in 31 (88.5%) by the second (k = 0.768). 12 weeks mortality was 20%. CONCLUSION: Peribronchial focal lesions are a common finding in early-IPA whatever the GM value during neutropenia and our findings reinforce the efficiency of a preemptive approach. ADVANCES IN KNOWLEDGE;: Peribronchial focal lesions, which are classically described in airway invasive aspergillosis, are a common finding in early-IPA in hematological cancer patients with prolonged neutropenia regardless of the GM value, and such peribronchial lesions should reinforce the possibility of IPA.
Authors: D Caillot; O Casasnovas; A Bernard; J F Couaillier; C Durand; B Cuisenier; E Solary; F Piard; T Petrella; A Bonnin; G Couillault; M Dumas; H Guy Journal: J Clin Oncol Date: 1997-01 Impact factor: 44.544
Authors: C Henzler; T Henzler; D Buchheidt; John W Nance; C A Weis; R Vogelmann; U Benck; T Viergutz; T Becher; T Boch; S A Klein; D Heidenreich; L Pilz; M Meyer; P M Deckert; W-K Hofmann; S O Schoenberg; M Reinwald Journal: Sci Rep Date: 2017-06-30 Impact factor: 4.379