PMC4770625_01
Pulmonary computed tomography (CT). Nodular lesion with 28mm located in the right upper lobe, with ground-glass opacity; (a) pulmonary window and (b) tissues window
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F1
POLO-AML-2, presenting later with febrile neutropenia. Pulmonary CT revealed a nodular lesion with 28mm located in the right upper lobe, with ground-glass opacity [Figure 1].
Upper endoscopic ultrasound (EUS). Ill-defined hypoechoic paraesophageal lesion, 30 x 22 mm with a central annular image, and no vascular flow
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F2
Given the absence of clinical improvement despite broad-spectrum antibiotherapy (imipenem and vancomycin), with no cultural growth in septic screen, upper endoscopic ultrasound (EUS) was performed, revealing an ill-defined hypoechoic paraesophageal lesion, 30 x 22 mm [Figure 2], with a central annular image, and no vascular flow [Figure 3].
Upper endoscopic ultrasound (EUS). Ill-defined hypoechoic paraesophageal lesion, 30 x 22 mm with a central annular image, and no vascular flow
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F3
Given the absence of clinical improvement despite broad-spectrum antibiotherapy (imipenem and vancomycin), with no cultural growth in septic screen, upper endoscopic ultrasound (EUS) was performed, revealing an ill-defined hypoechoic paraesophageal lesion, 30 x 22 mm [Figure 2], with a central annular image, and no vascular flow [Figure 3].
EUS histology. Abundant presence of neutrophils, macrophages, and ciliated columnar cells; no neoplastic cells were identified (hematoxylin and eosin [H and E, 200x])
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F4
Cook Medical) was performed (two passages). Cytology was consistent with inflammation [Figure 4], with no blast cells, and lesion microbiology was positive for Aspergillus fumigatus.