Intra-abdominal Hemorrhage due to Splenic Vein Aneurysm Rupture Caused by Invasive Aspergillosis During Treatment for Advanced Non-small-cell Lung Cancer

Ryutaro Hirama; Masato Kono; Takeshi Kobayashi; Yuiko Oshima; Kenichiro Takeda; Koichi Miyashita; Hideki Miwa; Akari Tsutsumi; Yoshihiro Miki; Dai Hashimoto; Yoshiro Otsuki; Hidenori Nakamura

doi:10.2169/internalmedicine.9714-22

This article has now been updated. Please use the final version.

Intra-abdominal Hemorrhage due to Splenic Vein Aneurysm Rupture Caused by Invasive Aspergillosis During Treatment for Advanced Non-small-cell Lung Cancer

Ryutaro Hirama, Masato Kono, Takeshi Kobayashi, Yuiko Oshima, Kenichiro Takeda, Koichi Miyashita, Hideki Miwa, Akari Tsutsumi, Yoshihiro Miki, Dai Hashimoto, Yoshiro Otsuki, Hidenori Nakamura

Author information

Ryutaro Hirama
Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, Japan
Masato Kono
Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, Japan
Takeshi Kobayashi
Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, Japan
Yuiko Oshima
Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, Japan
Kenichiro Takeda
Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, Japan
Koichi Miyashita
Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, Japan
Hideki Miwa
Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, Japan
Akari Tsutsumi
Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, Japan
Yoshihiro Miki
Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, Japan
Dai Hashimoto
Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, Japan
Yoshiro Otsuki
Department of Pathology, Seirei Hamamatsu General Hospital, Japan
Hidenori Nakamura
Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, Japan

Keywords: intra-abdominal hemorrhage, splenic vein aneurysm, invasive aspergillosis, non-small-cell lung cancer

JOURNAL OPEN ACCESS Advance online publication

Article ID: 9714-22

DOI https://doi.org/10.2169/internalmedicine.9714-22

The final version of this article is now available: Vol. 62 (2023), No. 3 pp. 423-429

Details

Abstract

A 71-year-old man was admitted for left-sided chest pain. He had a history of diabetes, treatment with epidermal growth factor receptor-tyrosine kinase inhibitor for advanced non-small-cell lung cancer, and corticosteroid treatment for underlying lung diseases. Chest computed tomography showed consolidations in the bilateral lower lobes, and Aspergillus fumigatus was detected by bronchoscopy. Invasive pulmonary aspergillosis was suspected, and antifungal therapy with voriconazole was initiated; however, the patient passed away suddenly. Autopsy revealed disseminated Aspergillus infection and intra-abdominal hemorrhage due to the rupture of a splenic vein aneurysm caused by Aspergillus necrotizing vasculitis, which was considered the cause of death.

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