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Systemic aspergillosis may be a disease increased in immunocompromise terrain as HIV, chronic immunosuppressant/steroid use. We report the case of a 39-year-old female patient who had an antecedent of chronic leukemia treated. The patient developped focal neurologic deficits, mental status changes, headache. CT scan of the top shows an outsized left frontal hypodense, nonenhancing lesion with mass effect. Intra-operative cytopathology show perivascular lymphocyts. On microscopic study, we diagnosed true hyphae with septations Grocott + , vasculitis resulting in necrosis. On some areas, their was an abondant inflammation composed with small lymphocyts and plasmocyts. An immunostain with antibodies anti- CD20, anti-CD3, anti-CD5, anti-CD23, anti-IgD and anti- Kappa and Lamda was realize in hospital of Paris. Their was no argument for secondary localisation of CLL. Cerebral aspergillosis is never seen. His diagnosis is multidisciplinar. The pathologist got to exchange with clinicians and radiologists. Ibrutinib, an irreversible Bruton's tyrosine kinase (Btk) inhibitor, has dramatically improved progression-free and overall survival in patients with a spread of lymphoid malignancies within the midst of its therapeutic success, however, several cases of invasive fungal infections (IFI) in patients receiving ibrutinib have emerged We present a case of central systema nervosum (CNS) aspergillosis during a patient with chronic leukemia (CLL) on ibrutinib who had not received any previous or concurrent corticosteroid, chemo- or immunotherapy and was successfully managed with this life-threatening CNS infection.
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