Abstract
The histopatological examination was performed in search of the incidence, distribution of organ involvement and gravity of deep fungus infections in 82 cases (54 cases of acute leukemia, 8 cases of chronic leukemia and 20 cases of lymphoreticular disease), which were autopsied at our department during the 6 years from 1974 to 1979. The deep fungus infections were noted in 36 (66.7%) out of all cases with acute leukemia. Fifteen cases of them had two kinds of fungus infections. Among those in acute leukemia, candidiasis was the most frequent fungus infection being revealed in 26 out of 36 cases (72.2%), and was followed by aspergillosis (18 cases), mucormyosis (6 cases) and cryptococcosis (1 case). However, in candidiasis most cases did not show serious fungus infections, while 5 cases represented disseminated type and only one case showed severe lung involvement. On the other hand, mucormycosis unexceptionally represented large pulmonary hemorrhagic infarction and was fatal to all the 6 cases. Also, aspergillosis commonly involved the lung and was fatal to the two thirds of the 18 cases, Fungus infections were also demonstrated in 3 cases (37.5%) with chronic leukemia and 8 cases (40%) with lymphoreticular disease, although the number of the autopsy cases was small.
Finally, an evaluation of the clinical laboratory data was performed, and it was revealed that severe lymphocytopenia (less than 500/mm3) predisposed greatly to fungus infections. Therefore, it is assumed that deep fungus infections must be firstly suspected when marked lymphocytopenia is observed in the treatment of patients with leukemia and lymphoreticular disease.
