We experienced 3 cases of acute leukemia in which fungus ball of the lung developed during or after remission induction therapy. Case 1 was a 29-year-old man with acute myelogenous leukemia receiving DCMP therapy (daunorubicin, cytosine arabinoside, 6-mercaptopurine, prednisolone). Around the time of the onset of partial remission, fungus balls were detected in both lung fields, for which 5-fluorocytosine (5FC) was administered. With complete remission achieved by 7 courses of DCMP therapy, the patient was discharged. The right mass was eradicated, while the left mass was shrunk. Case 2 was a 36-year-old man with acute myelogenous leukemia receiving DCMP therapy. After complete remission was attained, a fungus ball appeared in the right upper lung field, for which 5FC was administered. Subsequent examination at the outpatient clinic showed that the mass still remained. Case 3 was a 42-year-old man who developed a fungus ball at the left hilus during induction therapy for adult T cell leukemia. 5FC produced no change in the mass. Remission of adult T cell leukemia was not attained, and the patient died of interstitial pneumonia.
Though acute leukemia is frequently complicated by mycosis of the lung, the typical fungus ball as seen in the present cases is rarely observed. The clinical picture of fungus ball was discussed.
