CTICasesAcute Myeloid Leukemia (AML) and Invasive Pulmonary Aspergillosis
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Imaging findings
Initial chest radiograph and CT show diffuse, bilateral lung consolidation with small pleural effusions, which partially improved following chemotherapy. A subsequent CT shows new, large, consolidative opacities surrounded by ground-glass halos in the upper lobes.
Key takeaways
Patients presenting with acute myeloid leukemia (AML) and high white blood cell counts can develop non-infectious pulmonary complications such as pulmonary leukostasis or leukemic cell lysis pneumopathy. Following chemotherapy-induced neutropenia, these severely immunocompromised patients are at high risk for opportunistic fungal infections, and the development of consolidative nodules with ground-glass halos (the "halo sign") is highly suggestive of angioinvasive aspergillosis, which can be confirmed with serum or bronvoalveolar lavage galactomannan testing.
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