A Case of Cerebral Aspergillosis in a Patient with Chronic Lymphoid Leukemia

Cerebral aspergillosis commonly affects immunocompromised hosts, primarily patients on immunosuppressive therapy and those with acquired or immunodeficient states such as AIDS. We report a case of cerebral aspergillosis in a 39-year-old woman with a history of treated chronic lymphocytic leukemia (CLL). Multiple fragments of fixed tissues with formalin were freshly sent to the laboratory. An extemporaneous examination was performed by spreading. The rest of the sample was embedded in paraffin and studied according to the standard histological method with special stains and an immunohistochemical study. A microscopic observation showed abundant clusters of tangled mycelial filaments, Grocott+. At the edge, a nervous tissue was observed remodeled by an abundant inflammatory infiltrate consisting essentially of small lymphocytes and plasma cells. Additional immunohistochemistry was performed using anti-CD20, anti-CD3, anti-CD5, anti-CD23, anti-Bcl2, anti-Ki67, anti-IgD and anti-Kappa and Lamda antibodies. All taken together there were no further founding in support of a secondary localization of CLL. Cerebral aspergillosis is quite rare and often occurs in a context of immunosuppression. This case indicates the importance of a close collaboration between clinicians and pathologists for optimal patient care.