Intra-abdominal Hemorrhage Due to Splenic Vein Aneurysm Rupture Caused by Invasive Aspergillosis during Treatment for Advanced Non-small-cell Lung Cancer

Intern Med. 2023 Feb 1;62(3):423-429. doi: 10.2169/internalmedicine.9714-22. Epub 2022 Jun 21.

Abstract

A 71-year-old man was admitted for left-sided chest pain. He had a history of diabetes, treatment with epidermal growth factor receptor-tyrosine kinase inhibitor for advanced non-small-cell lung cancer, and corticosteroid treatment for underlying lung diseases. Chest computed tomography showed consolidations in the bilateral lower lobes, and Aspergillus fumigatus was detected by bronchoscopy. Invasive pulmonary aspergillosis was suspected, and antifungal therapy with voriconazole was initiated; however, the patient passed away suddenly. Autopsy revealed disseminated Aspergillus infection and intra-abdominal hemorrhage due to the rupture of a splenic vein aneurysm caused by Aspergillus necrotizing vasculitis, which was considered the cause of death.

Keywords: intra-abdominal hemorrhage; invasive aspergillosis; non-small-cell lung cancer; splenic vein aneurysm.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aneurysm, Ruptured* / complications
  • Aneurysm, Ruptured* / diagnostic imaging
  • Antifungal Agents / therapeutic use
  • Aspergillosis* / complications
  • Aspergillosis* / drug therapy
  • Aspergillus fumigatus
  • Carcinoma, Non-Small-Cell Lung* / complications
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Hemorrhage / drug therapy
  • Hemorrhage / etiology
  • Humans
  • Lung Diseases* / drug therapy
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / drug therapy
  • Male
  • Splenic Vein

Substances

  • Antifungal Agents