[The solitary pulmonary histoplasmoma].
A 63-year-old man who grows orchids as a hobby, fell ill with weakness and pain in his hips and legs 2 months after his latest trip to South America (Ecuador). The WBC count was 9900/microliters with unremarkable differential count while blood sedimentation rate was raised to 60/100 mm. The chest X-ray demonstrated in the right upper lobe a well-circumscribed coin lesion (3 cm diameter) of soft-tissue density, uncalcified and without cavitation. Computed tomography in addition revealed an enlarged lymph-node at the lower hilar pole, but no mediastinal lymphoma. Bronchoscopy demonstrated narrowing of a subsegmental ostium of the 6th segment on the right. An attempt at transbronchial biopsy failed. As a peripheral bronchial carcinoma was suspected, a posterolateral thoracotomy was performed (4 months after the trip to Ecuador). Rapid histological examination was negative for tumour and the lesion was therefore enucleated. Histologically (Grocott silver staining) a histoplasmoma was diagnosed. Several serum samples were positive for precipitating (M-band) and complement-binding antibodies (titre 12 days preoperatively was 1:16). The postoperative course was without complication. No anti-histoplasma antibodies were demonstrable 1 year postoperatively.
Berwanger
I
I
Abteilung Lungenchirurgie, Universität Freiburg.
Hasse
J
J
Schaefer
H E
HE
Kappe
R
R
Müller
J
J
D000908:Antibodies, Fungal / Q000097:blood; D000935:Antifungal Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D006658:Histoplasma / Q000276:immunology; D006660:Histoplasmosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D013020:South America; D014057:Tomography, X-Ray Computed; D014195:Travel
D000908:Antibodies, Fungal; D000935:Antifungal Agents
Solitäres pulmonales Histoplasmom.