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Case Reports
. 2014 Apr 11:2014:bcr2013203335.
doi: 10.1136/bcr-2013-203335.

Histoplasmosis mimicking primary lung neoplasm

Minesh Kooblall  1 , Barry Keane, Grainne Murray, Eddie Moloney
Affiliations
Case Reports

Histoplasmosis mimicking primary lung neoplasm

Minesh Kooblall et al. BMJ Case Rep. .

Abstract

A 70-year-old man, ex-smoker with a 3-pack-year smoking history, presented with a 5-week history of persistent cough. There were no positive findings on clinical examination. The patient's chest X-ray showed a nodular density in the right lung, initially thought to be malignant. After an extensive workup which included CT-guided lung biopsies, bronchoscopies, positron emission tomography scanning, among many other investigations, discussion at the respiratory multidisciplinary team meeting, and a right upper lobe lung resection, a diagnosis of histoplasmosis was performed.

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Figures

Figure 1
Figure 1
CT taken on 14 June 2011, spiculated right upper lobe lesion.
Figure 2
Figure 2
H&E stain of section from 18 mm lung nodule showing xanthogranulomatous inflamation with foamy macrophages containing multiple intracytoplasmic cysts.
Figure 3
Figure 3
These intracytoplasmic cysts stain positive for Grocott's methenamine silver stain. The morphology is consistent with histoplasmosis.
See this image and copyright information in PMC

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