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Localized invasive pulmonary aspergillosis in patients with neutropenia. Effectiveness of surgical resection
Author(s) -
Moreau Philippe,
Zahar JeanRalph,
Milpied Noël,
Baron Oliver,
Mahé Béatrice,
Wu Depei,
Germaud Patrick,
Despins Philippe,
Delajartre AnneYvonne,
Harousseau JeanLuc
Publication year - 1993
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19931201)72:11<3223::aid-cncr2820721115>3.0.co;2-r
Subject(s) - medicine , aspergillosis , neutropenia , resection , surgical resection , surgery , pulmonary aspergillosis , pneumonectomy , radiology , lung , chemotherapy , immunology
Background. Invasive pulmonary aspergillosis (IPA) is a major cause of morbidity and mortality in patients with neutropenia. Two severe complications with poor outcome can be observed after apparently successful IPA medical treatment: severe hemoptysis and IPA relapse during subsequent cytotoxic treatments. Early surgical therapy has not been considered routinely in the management of localized IPA. Methods. Six consecutive patients (four women, two men; median age, 52 years) with localized cavitating IPA diagnosed during chemotherapy‐induced aplasia were treated with early surgical resection after hematologic recovery. Results. All patients received a lobectomy. Surgery was uneventful. This procedures allows patients to proceed with further intensive chemotherapy and/or bone marrow transplantation without IPA reactivation. Conclusions. For selected patients, surgical resection of localized IPA with unique cavitating lesion, which prevents hemoptysis and IPA recurrence and allows for subsequent cytotoxic treatment, may be recommended.