Toxoplasmosis complicating lung cancer: a case report

Abstract

Toxoplasmosis complicating lung cancer has been described only rarely. Here, we report a case of acute Toxoplasma gondii infection in a patient with squamous lung cancer. A 64-year-old woman was admitted to our hospital with a history of cough of 6 months' duration and chest pain of 1 week's duration. Further examination revealed multiple swollen lymph nodes, palpable on the top of the right collarbone and without tenderness. The chest X-ray, bronchoscopy, and computed tomography scan confirmed squamous carcinoma of the right lung. The Wright-stained bronchoalveolar-lavage fluid cytology diagnosis was positive for T. gondii and tachyzoites were detected. All of them were of free type (ectocytic), without intracellular parasites. Serological examination revealed that the anti-T. gondii immunoglobulin (Ig) M and IgG antibodies were positive. Unfortunately the patient did not continue treatment and was lost to follow-up. Toxoplasmosis is a life-threatening opportunistic infection in patients with lung cancer. Prompt recognition of T. gondii infection among cancer patients with subsequent targeted treatment of toxoplasmosis could help alleviate symptoms and improve survival.

Keywords: Toxoplasma gondii; bronchoalveolar-lavage fluid; lung cancer; tachyzoite.

Figure 1

Wright-stained bronchoalveolar lavage fluid smears. Notes: (A–D) Arrows indicate extracellular “tachyzoites”, also known as “trophozoites”, which can be propagated within the nucleated cells. No intracellular parasites are present. Magnification ×1,000.