Diagnostic and Interventional Radiology
Chest Imaging - Original Article

Sequential morphological changes in follow-up CT of pulmonary mucormycosis

1.

Department of Radiology Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center

2.

Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.

Diagn Interv Radiol 2014; 20: 42-46
DOI: 10.5152/dir.2013.13183
Read: 517 Downloads: 305 Published: 03 September 2019

Abstract

PURPOSE: 
We aimed to describe the computed tomography (CT) features of pulmonary mucormycosis including sequential changes between follow-ups. 

 

MATERIALS AND METHODS: 
Between June 2001 and May 2011, five patients (three males and two females; median age, 43 years; age range, 13–73 years) who had been pathologically diagnosed with pulmonary mucormycosis constituted our study population. Their clinical and CT features including sequential changes over follow-ups were evaluated retrospectively. 

 

RESULTS: 
All patients were immunocompromised due to either hematologic diseases (n=3), diabetes mellitus (n=1), or steroid administration for autoimmune hepatitis (n=1). All patients had symptoms such as fever (n=5), tachycardia (n=1), or pleuritic chest pain (n=1) on admission. Regarding the clinical outcome after treatment, one patient died, and the remaining four recovered from the disease. In terms of initial CT features, the morphologies of pulmonary mucormycosis included a single mass (n=3), consolidation (n=1), or multiple masses (n=1). There were seven pulmonary lesions in total, 3–7 cm in size, which showed a CT halo sign (n=3), reversed-halo sign (n=2), or air-fluid levels (n=2). On follow-up CTs, the lesions of all patients contained necrosis. All three patients with a mass or masses with a CT halo sign on initial CT had a decreased surrounding halo followed by central necrosis, and the lesions gradually decreased in size on recovery. 

 

CONCLUSION: 
Pulmonary mucormycosis usually manifests as a mass or masses with a halo or reversed-halo sign on the initial CT scan followed by a decreased extent of surrounding ground-glass opacities with the development of internal necrosis during follow-up.

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