Invasive aspergillosis
1.4% in 2315 consecutive necropsies
In immunocompromised patients 11%
Boom AP,et al. J Clin Pathol 1991;44:452-4
症例報告
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Tresallet C, Nguyen-Thanh Q, Aubriot-Lorton MH, Akakpo JP, Al Jijakli A,
Cardot V, Chigot JP, Menegaux F. Small-bowel infarction from disseminated
aspergillosis. Dis Colon Rectum. 2004 Sep;47(9):1515-8
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Neutropenic patients
主訴：腹痛と腹満、発熱
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CT findings ： diffuse, small-bowel distention with a thickened, distal, ileum wall.
Emergency surgery was performed with resection and immediate anastomosis of the
distal ileum. Pathology of the small bowel showed a wall necrosis and invasion by
Aspergillus fumigatus.
Abdominal CT
Contrast enhanced axial CT scan shows diffuse small-bowel distention with a thickened wall of the
distal ileum, a target sign (arrow), and an inflammation of the perienteric fat.
Macroscopy of the small bowel
shows irregular mucosal ulcerations with disseminated necrosis areas,
and a thick, grey, necrotic debris recovering mucosa.
Pathological findings
Microscopy of the surgical specimen from the ileal resection demonstrates transmural infarction
with fibrin deposits recovering mucosa (hematoxylin and eosin; original magnification Å~2.5).
Pathological findings (Grocott’s)
Aspergillus fumigatus hyphal elements massively invade the wall of a submucosal muscular artery
(Grocotts methenamine silver; original magnification Å~40).
The disseminated invasive
aspergillosis of the alimentary tract
診断：
1. 症状がnonspecific
2. 腹痛、発熱
3. 腹部CT
4. 病理組織ー内視鏡
治療：
1. 抗真菌剤
2. 切除
3. Poor prognosis

Prof. Dr. med. Aurel PERREN Institute of Pathology University of

スライド 1

病理各論概論 Part II 病理解剖の手技_summary.pptx