Cytomegalovirus infection masquerading as carcinoma in a lung transplant patient.
In lung transplant patients, most infections produce radiographically diffuse or lobar infiltrates. Solitary nodules suggesting neoplasm may arise in lung transplant patients with lung infections. We describe a 45-year-old woman who underwent bilateral lung transplantation to treat bilateral bronchiectasis and lung fibrosis resulting from Hodgkin disease. Five months later, a solitary mass was identified on chest radiograph in the left upper lobe and left superior mediastinum. Low-power examination of wedge biopsies of the mass showed a florid proliferation of cells with clear to bubbly to eosinophilic cytoplasm and moderate nuclear atypia, proliferating fibroblasts, and necrosis, suggesting a clear cell carcinoma (possibly metastatic renal cell carcinoma). Intranuclear inclusions compatible with cytomegalovirus were identified on high-power examination and confirmed by immunohistochemistry. In lung transplant patients, a cytomegalovirus infection may mimic malignancy both radiographically and on initial histopathologic examination.
Allen
Timothy Craig
TC
Department of Pathology, University of Texas Health Center, Tyler 75708-3154, USA. Timothy.Allen@uthct.edu <Timothy.Allen@uthct.edu>
Bag
Remzi
R
Zander
Dani S
DS
Cagle
Philip T
PT
D002277:Carcinoma / Q000175:diagnosis*; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D016040:Lung Transplantation / Q000009:adverse effects*; D008875:Middle Aged