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Spontaneous Pneumothorax in Patients with Leukemia: First Sign of Invasive Mycosis?

Corrado Girmenia, MD; Vittorio Donato, MD; Anna Paola Iori, MD; and Pietro Martino, MD
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From Universita degli Studi La Sapienza, Rome, Italy. Requests for Reprints: Pietro Martino, MD, Istituto di Ematologia, Via Benevento 6, 00161 Rome, Italy. Grant Support: In part by grant 92.0221.939 from Progetto Finalizzato Applicazioni Cliniche alla Ricerca Oncologica, Centro Nazionale delle Ricerche, Italy.

Copyright 2004 by the American College of Physicians

Ann Intern Med. 1993;118(9):707-708. doi:10.7326/0003-4819-118-9-199305010-00008
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Two patients with leukemia, who underwent remission induction chemotherapy and allogeneic bone marrow transplantation, respectively, reported chest pain and dyspnea after recovery from neutropenia. In both patients, chest radiographs showed only a pneumothorax, whereas computed tomographic scanning also showed a peripheral pseudomycetoma. Antifungal treatment was instituted. The occurrence of spontaneous pneumothorax in patients with hematologic malignancies, particularly after recovery from neutropenia, may indicate the presence of a subpleural infection. Computed tomographic scanning can reveal peripheral pulmonary lesions that are not detected by chest roentgenography.


Grahic Jump Location
Figure 1.
Computed tomographic scan done in patient 1 showing a right small pneumothorax and a peripheral pseudomycetoma in the homolateral middle-lung field.
Grahic Jump Location




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