PDF(Pubmed)
Abstract：
Invasive aspergillosis (IA) represents a common form of fungal infection caused by various species of Aspergillus that most frequently affect immunocompromised patients. Typically, this disease occurs preferentially in high-risk groups including patients infected with the human immunodeficiency virus (HIV), patients with leukemia, patients with autoimmune diseases, and organ transplant patients undergoing medical immunosuppression. Considered the second most common cause of opportunistic fungal infection in humans after Candida albicans, this pathogen predominantly affects the lungs, but it may also spread by a hematogenous route to various organs and have a heterogeneous presentation. Owing to its high iodine levels, high perfusion, and enclosed capsule, the thyroid gland is considered to have a lower susceptibility to microbial invasion, and it is fairly uncommon to find associated infectious nodules. In metabolic imaging, 18F-FDG-PET/CT has become increasingly useful for detecting a wide range of infectious and inflammatory diseases and is already the gold standard for certain indications. According to the literature, no studies of hypermetabolic nodular thyroid aspergillosis on 18F-FDG-PET/CT confirmed on histology have yet been reported. Here, we report the first case of a patient with a heterogeneous presentation of IA and the presence of a hypermetabolic nodule in the thyroid with a surprising result.
摘要：
侵袭性曲霉病（IA）是由各种曲霉引起的常见真菌感染形式，最常影响免疫功能低下的患者。通常,这种疾病优先发生在高危人群中，包括感染人类免疫缺陷病毒（HIV）的患者，白血病患者，自身免疫性疾病患者，和接受医学免疫抑制的器官移植患者。被认为是人类机会性真菌感染的第二大常见原因，仅次于白色念珠菌，这种病原体主要影响肺部，但它也可能通过血源性途径传播到各种器官，并具有异质性表现。由于其高碘水平，高灌注,和封闭的胶囊，甲状腺被认为对微生物入侵的敏感性较低，发现相关的感染性结节是相当罕见的。在代谢成像中，18F-FDG-PET/CT对于检测多种感染性和炎症性疾病越来越有用，并且已经成为某些适应症的金标准。根据文献,尚未报道组织学证实的18F-FDG-PET/CT高代谢性结节性甲状腺曲霉病的研究。这里,我们报告了首例患者的IA异质性表现和甲状腺中存在高代谢结节，结果令人惊讶。
