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185 BRONCHOALVEOLAR CARCINOMA OF THE LUNG:STACHYBOTRYS NIDUS AS CASUATION BY PCR.
  1. G. Ordog
  1. H. Mayo Hospital, Valencia, CA

Abstract

An investigation of a family's illness included an environmental assessment of the townhouse, confirming a major mold infestation. The airborne spore count was elevated for pathogenic and toxigenic mold species including Stachybotrys chartarum, Aspergillus species, Penicillium species, and Chaetomium. There was a temporal relationship between the 3-year exposure to the mold and the development of symptoms in the family members. Family members exhibited signs and symptoms of mycotoxicosis, recurrent infections, immune dysfunction, CFIDS, toxic leukoencephalopathy, hypersensitivity pneumonitis, reactive airways dysfunction (RADS), and fibromyalgia. They each had elevated serum ELISA tests for aflatoxin, trichothecene, and satratoxin. The hypersensitivity pneumonitis panel had elevated IgG antibodies to the mold found on the environmental testing. Bulk sampling of moldy building materials confirmed levels of 20 mycotoxins from the aflatoxin, trichothecene, and satratoxin groups, positive in microgram per gram material amounts. The family was evacuated from this home. The mother, aged 52, had a high-resolution spiral CT scan of the chest, which showed a 1 cm pulmonary nodule. Because of the pulmonary exposure to carcinogenic mycotoxins, the patient had a fine-needle biopsy of the nodule, showing bronchoalveolar carcinoma. A lobectomy was done, and the nodule was bisected, confirming the presence of bronchoalveolar carcinoma. One section was analyzed by Rainbow Children's Hospital in Cleveland, OH and was positive for Stachybotrys PCR in the nidus of the nodule. There have been two previous reports of inhaled Aspergillus sp. causing bronchogenic carcinoma. This is the first report of a nidus of Stachybotrys, as measured by PCR, causing the development of bronchoalveolar carcinoma. The surgery was curative at 5-year follow-up, but the patient continued to have symptoms of the above-named complications of mold exposure.

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