Infect Chemother.  2012 Dec;44(6):465-468. 10.3947/ic.2012.44.6.465.

Multicystic Mass Infection in the Subcutaneous Tissue around Joint Developed by Aspergillus in a Liver Transplant Patient

• Song JE
• Oh DH
• Kim MH
• Kim YC
• Ahn JY
• Jeong SJ
• Ku NS
• Kim HW
• Kim SB
• Han SH
• Choi JY
• Kim CO
• Song YG
• Kim JM

• KMID: 1806934
• DOI: http://doi.org/10.3947/ic.2012.44.6.465

Abstract

Invasive aspergillosis can be occured in immune-compromised patients with hematopoietic stem cell transplantation, solid organ transplantation and prolonged neutropenia. The major area of invasive aspergillosis involves the sinopulmonary tract but can occur around the joint areas rarely. A 72-year-old man, who had received a liver transplant 6 years earlier, presented with a mass lesion around the right knee joint that developed 3 year earlier. Knee MRI revealed a multicystic subcutaneous mass around the knee joint. An excision was performed, and many fungal hyphae that were morphologically most consistent with Aspergillus spp. were observed in tissue. After amphotericin B therapy for 2 weeks, the patient did not show any evidence of a recurrence of invasive aspergillosis for 15 months. As Aspergillus spp. can cause a range of infections in solid organ transplants, invasive aspergillosis must be considered in patients with a recurrent cystic mass lesion.

Keyword

Aspergillus; Liver transplantation; Cysts

MeSH Terms

Amphotericin B
Aspergillosis
Aspergillus
Hematopoietic Stem Cell Transplantation
Humans
Hyphae
Joints
Knee
Knee Joint
Liver
Liver Transplantation
Neutropenia
Organ Transplantation
Recurrence
Subcutaneous Tissue
Transplants
Amphotericin B

Figure

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  Figure 1 Findings of the right lower extremity MRI in (A) coronal view (B) sagittal view show the 2.7×1.9×3.1 cm sized multicystic mass at the anteromedial aspect of the proximal lower leg (Arrow).

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  Figure 2 Pathologic examination of the excisional mass (A) D-PAS and (B) GMS stain showing acute suppurative inflammation with giant cells (arrow) and the presence of many fungal hyphae (arrow, that were morphologically most consistent with Aspergillus spp.

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