一名 61 岁女性因 3 个月内反复肺炎而转诊，且对抗生素治疗反应不足，出现咳嗽和右侧胸口剧烈疼痛。此前，她因局部晚期非小细胞肺癌（鳞状细胞癌）接受了右上肺叶切除术，随后进行辅助化疗，随后因胸膜皮肤瘘而接受了聚四氟乙烯网插入的部分胸壁切除术。进行 18FDG 加 68Ga 标记的成纤维细胞活化蛋白抑制剂 (68Ga-FAPI) PET/CT 扫描以排除非小细胞肺癌复发。支气管镜检查和支气管内超声引导下经支气管细针抽吸淋巴结的病理检查显示没有恶性肿瘤的证据，但微生物学证实中叶有烟曲霉感染。因此，患者从抗生素治疗转向抗真菌治疗；未启动二线肿瘤治疗。版权所有 © 2024 Wolters Kluwer Health, Inc. 保留所有权利。

A 61-year-old woman, referred for recurrent pneumonia over a period of 3 months with insufficient response to antibiotic treatment, presented with coughing and intense right-sided chest pain. Previously, she underwent right upper lobectomy for locally advanced non-small cell lung cancer (squamous cell carcinoma) followed by adjuvant chemotherapy and subsequent partial chest wall resection with polytetrafluoroethylene net insert due to a pleurocutaneous fistula. 18FDG plus a 68Ga-labeled fibroblast activation protein inhibitor (68Ga-FAPI) PET/CT scans were performed to rule out non-small cell lung cancer recurrence. Pathological workup with bronchoscopy and endobronchial ultrasound-guided transbronchial fine-needle aspiration of the lymph nodes showed no evidence of malignancy, but microbiology confirmed Aspergillus fumigatus infection of the middle lobe. Thus, the patient transitioned from antibiotic to antifungal therapy; no second-line oncologic treatment was initiated.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.