1、Invasive aspergillosis,1.4% in 2315 consecutive necropsiesIn immunocompromised patients 11%Boom AP,et al. J Clin Pathol 1991;44:452-4,症例報告,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.
2、 Dis Colon Rectum. 2004 Sep;47(9):1515-8Neutropenic patients主訴：腹痛腹満、発熱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
3、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 wit
4、h 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 2.5).,Patho
5、logical findings (Grocotts),Aspergillus fumigatus hyphal elements massively invade the wall of a submucosal muscular artery (Grocotts methenamine silver; original magnification 40).,The disseminated invasive aspergillosis of the alimentary tract,診断：1. 症状nonspecific2. 腹痛、発熱3. 腹部CT4. 病理組織内視鏡治療：抗真菌剤切除Poor prognosis,
