title: Primary pulmonary botryomycosis with multiple adjacent organ involvement mimicking mucosa-associated lymphoid tissue lymphoma.
abstract: Botryomycosis is an unusual chronic suppurative disease characterized by the histological finding of sulphur granules containing the causative bacteria in an abscess. We describe a previously healthy 14-year-old girl who presented with chronic productive cough. Chest computed tomography (CT) revealed a right lower mass with involvement of the parietal pleura, chest wall, diaphragm, liver and costovertebral junction. Thoracostomy biopsy was performed due to suspicion of low-grade mucosa-associated lymphoid tissue lymphoma. However, histological analysis revealed a pulmonary botryomycosis. The right lower lung mass completely resolved after 3 months of antibiotics treatment. This case emphasizes that primary pulmonary botryomycosis with extensive contiguous involvement may not be distinguishable from lung cancer, lymphoma or fungal infection on chest CT.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Yew-Loong
authors.initials: YL
authors.lastname: Leong
authors.forename: Yuang-Shuang
authors.initials: YS
authors.lastname: Liaw
authors.forename: Yih-Leong
authors.initials: YL
authors.lastname: Chang
authors.forename: Yung-Chie
authors.initials: YC
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D020171:Botrytis / Q000302:isolation & purification*; D003937:Diagnosis, Differential; D003964:Diaphragm / Q000382:microbiology; D005260:Female; D006801:Humans; D008099:Liver / Q000382:microbiology; D008172:Lung Diseases, Fungal / Q000175:diagnosis*; D008175:Lung Neoplasms / Q000175:diagnosis*; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis*; D010994:Pleura / Q000382:microbiology; D013904:Thoracic Vertebrae / Q000382:microbiology; D035441:Thoracic Wall / Q000382:microbiology