Autopsy and Case Reports
https://www.autopsyandcasereports.org/article/doi/10.4322/acr.2020.191
Autopsy and Case Reports
Autopsy Case Report

The grim reaper evading modern medicine: aspergillosis, adenovirus, and Hodgkin lymphoma

Larry Nichols; Justin Armstrong; Cody Atkinson

Downloads: 1
Views: 1066

Abstract

Illustrative cases of diseases that are difficult to suspect and diagnose can serve as useful reminders. Invasive pulmonary aspergillosis and adenovirus hepatitis are two such diseases, both revealed by autopsy in this case of Hodgkin lymphoma refractory to chemotherapy treated with allogeneic hematopoietic stem cell transplantation complicated by these two fatal infections. This patient was cured of Hodgkin lymphoma, Clostridioides difficile colitis and thrombotic thrombocytopenic purpura using the marvels of modern medicine. This case illustrates many features of aspergillosis and adenovirus hepatitis, shows the value of autopsy in revealing diagnoses, and illustrates the limits of modern medicine, which should serve as a mental spur in our efforts to advance medical science, to try to defeat the numerous demons of disease, who seem to keep outwitting us.

Keywords

Aspergillosis, Adenovirus, Hepatitis, Hodgkin lymphoma: Autopsy

References

Nichols L.

 

The Larry Nichols Collection [cited 2020 Apr 20]. Available from: https://histosrv.vub.ac.be/mercer/

 

Piris MA, Medeiros LJ, Chang KC. Hodgkin lymphoma: a review of pathological features and recent advances in pathogenesis.

 

 

Pathology. 2020;52(1):154-65. [https://doi.org/10.1016/j.pathol.2019.09.005]. [PMID:31699300]

 

Fatobene G, Linardi CDCG, Moreira F, et al. Reassessment of risk factors and long-term results of autologous stem cell transplantation in relapsed and refractory classical Hodgkin lymphoma.

 

 

Hematol Oncol. 2019;37(3):310-3. [https://doi.org/10.1002/hon.2604]. [PMID:30847943]

 

Obeid KM. Infections with DNA viruses, adenovirus, polyomaviruses, and parvovirus B19 in hematopoietic stem cell transplant recipients and patients with hematologic malignancies.

 

 

Infect Dis Clin North Am. 2019;33(2):501-21. [https://doi.org/10.1016/j.idc.2019.02.005]. [PMID:30940465]

 

Schaberg KB, Kambham N, Sibley RK, Higgins JPT. Adenovirus hepatitis: clinicopathologic analysis of 12 consecutive cases from a single institution.

 

 

Am J Surg Pathol. 2017;41(6):810-9. [https://doi.org/10.1097/PAS.0000000000000834]. [PMID:28296681]

 

Alves VAF. Acute viral hepatitis: beyond A, B, and C.

 

 

Surg Pathol Clin. 2018;11(2):251-66. [https://doi.org/10.1016/j.path.2018.02.014]. [PMID:29751873]

 

Botros M, Sikaris KA. The de ritis ratio: the test of time.

 

 

Clin Biochem Rev. 2013;34(3):117-30. [PMID:24353357]

 

Ledoux MP, Guffroy B, Nivoix Y, Simand C, Herbrecht R. Invasive pulmonary aspergillosis.

 

 

Semin Respir Crit Care Med. 2020;41(1):80-98. [https://doi.org/10.1055/s-0039-3401990]. [PMID:32000286]

 

Schweer KE, Jakob B, Liss B, et al. Domestic mould exposure and invasive aspergillosis-air sampling of Aspergillus spp. spores in homes of hematological patients, a pilot study.

 

 

Med Mycol. 2016;54(6):576-83. [https://doi.org/10.1093/mmy/myw007]. [PMID:26941254]

 

Li Z, Lu G, Meng G. Pathogenic fungal Infection in the Lung.

 

 

Front Immunol. 2019;10:1524. [https://doi.org/10.3389/fimmu.2019.01524]. [PMID:31333658]

 

Love GL. Hyalohyphomycoses. In: Procop GW, Pritt BS, editors.

 

 

Pathology of infectious diseases. Philadelphia: Elsevier Saunders; 2015. p. 461-490.

 

Bays DJ, Thompson GR 3rd. Fungal infections of the stem cell transplant recipient and hematologic malignancy patients.

 

 

Infect Dis Clin North Am. 2019;33(2):545-66. [https://doi.org/10.1016/j.idc.2019.02.006]. [PMID:31005138]

 

El-Baba F, Gao Y, Soubani AO. Pulmonary aspergillosis: what the generalist needs to know.

 

 

Am J Med. 2020;133(20):668-74. [https://doi.org/10.1016/j.amjmed.2020.02.025]. [PMID:32240631]

 

Schuetz AN, Walsh TJ. Importance of fungal histopathology in immunocompromised pediatric patients: it’s not just “Aspergillus” anymore.

 

 

Am J Clin Pathol. 2015;144(2):185-7. [https://doi.org/10.1309/AJCPE3NSJ2RYLENS]. [PMID:26185304]

 

Fernández-Cruz A, Magira E, Heo ST, Evans S, Tarrand J, Kontoyiannis DP. Bronchoalveolar lavage fluid cytology in culture-documented invasive pulmonary aspergillosis in patients with hematologic diseases: analysis of 67 episodes.

 

 

J Clin Microbiol. 2018;56(10):e00962-18. [https://doi.org/10.1128/JCM.00962-18]. [PMID:30021823]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Submitted date:
04/17/2020

Accepted date:
06/03/2020

Publication date:
09/02/2020

5f4fe89b0e8825670e7dc2e2 autopsy Articles
Links & Downloads

Autops Case Rep

Share this page
Page Sections