Pulmonary Mucormycosis with Reversed Halo Sign on Computed Tomography of Patient with Leukemia

2020 
: The patient was a male in his 60s, who had undergone bone marrow transplantation because of lymphoblastic leukemia. He suffered from chest pain two weeks after the transplantation. A chest computed tomography(CT) showed reversed halo sign( RHS) in the right upper lobe of the lung. A bronchoscopic lung biopsy revealed mycelia, and the patient was diagnosed with pulmonary mucormycosis. Although antifungal drugs were administered, no significant improvements were observed. A right upper lobectomy of the lung was successfully performed, and no postoperative complications occurred. Pathological examination found nodular lesions with extensive necrotic foci inside, and inflammatory granulation tissue and mucormycosis with hyphae (+) were found through Grocott staining. RHS in leukemia patients with neutropenia is specific to pulmonary mucormycosis. Pulmonary mucormycosis is a life-threatening disease, and urgent treatment intervention including surgical treatment is advisable.
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