Acute lymphoblastic leukemia with central nervous system Aspergillus infection: a case report and literature review

Figure 1:The head MRI of the patient was performed before the operation, an intracranial occupying lesion was considered in the right occipital lobe,but the edema was worse than before, indicating that the disease had progressed. Figure2：During the operation, A：a few pale-yellow changes were observed on the brain surface, and the adhesion of the space-occupying lesion to the surrounding brain tissue was obvious with a thick capsule containing pus；B：there was a brain abscess-like lesion with coffee-colored pus inside，Some of the pus was taken for NGS and culture；C：The capsule was complete and was completely resected. Figure3：A：The patient's pus specimen was stained with fluorescent dyes and observed under a microscope at 400x where aspergillus hyphae were detected；B：NGS testing of the pus indicated infection with aspergillus udagawae .C：The routine pathological examination of the capsule tissue indicated "aspergillosis with abscess formation" in the right Occipital lobe .（HE，magnification, x200，The arrow in the picture indicates aspergillus）；D：The routine pathological examination of the capsule tissue indicated "aspergillosis with abscess formation" in the right Occipital lobe .（PAS，magnification, x200，The arrow in the picture indicates aspergillus）. Figure4：Head CT examination after operation showed satisfactory results.